Tuesday 11 December 2018

A loose wire shaped like a noose just says so much

The interchangeable men in the smart navy suits talk a great game, says Brendan O'Connor. But Irish people see beyond it

SOLUTIONS, NOT SOUNDBITES: Taoiseach Leo Varadkar and Minister for Health Simon Harris during the government press conference on the cervical cancer controversy
SOLUTIONS, NOT SOUNDBITES: Taoiseach Leo Varadkar and Minister for Health Simon Harris during the government press conference on the cervical cancer controversy
Brendan O'Connor

Brendan O'Connor

The term 'safe space' can be a bit overused these days, but if ever there was an argument for a safe space it is in young people's mental health services. Those who work in young people's mental health will tell you that many of the children who present to them are not presenting with a pure illness or a simple chemical imbalance or pathology. They are there because of stresses in their lives, things like bullying, abuse, family problems, and increasingly, life pressures that are exacerbated by the online world.

As Dr Mike Shooter CBE, child psychiatrist and former president of the Royal College of Psychiatrists, wrote in his recent book Growing Pains, while many children will need medication to solve their problems, sometimes the first step in helping these kids is to give them "the opportunity to tell their story, to someone they trust, who will listen to them with patience and respect, who will recognise that this may be the first time they have found the courage to share it with anyone".

So here are young people for whom the world can be a maelstrom of chaos and pain. And the first thing these kids need when they seek help is a refuge from all that.

Here is the picture painted by consultant in paediatric psychology Kieran Moore of what that refuge, that safe space, looked like for children and adolescents seeking sanctuary in Wexford and Waterford: a building not fit for purpose, slugs crawling across the floor, a loose cable shaped like a noose, no privacy, barely blinds on the windows, intimate conversations conducted on a chair in a space that was open to anyone to walk through.

No facilities to conduct examinations, nowhere to take bloods, five staff working in one room. Staff under immense pressure and stress because there weren't enough of them, many of them on the verge of burnout as they tried to deal with a deluge of referrals, many of whom were not suitable candidates to be helped by the mental health services, but were clearly bounced in there from other areas because there was nowhere else to send them.

Kieran Moore says he can't do it anymore, so after 16 years of trying to provide a service to the young people of the South East, he is giving up. Two of his colleagues are resigning, too. This is not, by the way, a coordinated move. For now there will be no consultant psychiatrists to oversee operations so it seems like from next month, there will be no mental health services for young people in Waterford and Wexford. The HSE say it is trying to recruit someone.

We talk a hell of a lot about mental health in this country. We pride ourselves on this being a new era, where it's okay not to be okay, where young men and women can confide in their friends, where you will even get a sympathetic hearing in the dressing room if you admit you are struggling. We act as if mental health is something we can magically fix by people just talking about it. And there's no doubt being able to talk about it is a step in the right direction.

But none of this is any good if there are no services to access once you have accepted you need help. We act as if mental health can be farmed out to some kind of care in the community model, where your pals will make you okay. But, of course, it's not.

It was telling that on the RTE news last week, after a report about this situation, they then gave out phone numbers for anyone who wanted to reach out and get help. So they gave out the numbers for the Samaritans and Pieta House.

This is the standard thing we do in this situation. Not RTE's fault. But isn't there something wrong there, when we have an item bemoaning our mental health services, and the only help we can offer is for people to go to two charities for help. Because we all know, there'd be no point in giving out any kind of government number for mental health services.

Shure that would be mad, Ted.

We all know Leo Varadkar and the lads are concerned about mental health. It's one of those fashionable issues that probably ticks boxes with the younger demographic. So earlier this year we saw Leo out encouraging people to take a break from their electronic devices - in an effort to improve their mental health.

This is part of the Healthy Ireland message, that small changes can make improvements to your health. And it's probably good advice for most of us, who are reasonably mentally healthy, but who recognise the need to mind our mental health. But, ultimately, it's more talk.

When attacking his rivals last week for what he called their Trump-like tactics and their alleged focus on spin while he was a man of action, Housing Minister Eoghan Murphy then turned around and said: "They make posters; I make progress." It was right up there with Tony Blair saying it wasn't a time for soundbites but he could feel the hand of history on him. This was while Murphy was saying that the important thing wasn't that the Government has been overestimating the number of new houses by 60pc since it got into office, but that there was a sharp jump in houses coming onstream in the past two years.

You look at them sometimes and it feels like everything that is wrong with the corporate culture of ass-covering and bulls**tting while doing nothing effective has now infected politics. Look at Leo with his Spanish counterpart, new prime minister Pedro Sanchez. Sanchez is supposed to be a lefty and, still, the two of them looked like two corporate hot shots signing a deal. Joshing away about Shamrock Rovers.

Trudeau, Macron, the same thing. Interchangeable men in smart navy suits, monotone ties, never any crazy patterns - too risky, not calming - and impeccable manners and love posing for pictures and issuing soundbites. But you get the feeling it's all just bulls**t. It's all about setting a certain tone of civilisation and calmness, no matter what's happening underneath.

It's the same thing ultimately as Trump claiming he had a terrific deal and brought peace in our time with North Korea in Singapore. Just don't look at the detail. Don't look under the bonnet. Just admire the paint job.

Remember the calming, contrite words for the women affected by the CervicalCheck scandal? This was a shame and everything would be done to help them as soon as possible. After all, says Leo, Emma Mhic Mhathuna could have been my sister, or one of my friends. Empathy alert!

And then we learn that nothing was happening, that the childcare, the counselling, the transport to appointments, the medical cards was all too slow in coming. You even got the feeling Leo was feeling a bit tetchy with these confounded women at times, when he complained that they weren't getting back quickly enough about mediation.

And then the inquiry, that would be swift and decisive. Except Dr Scally was given far too wide ranging a brief, and the usual obstruction and delaying tactics were being used by the HSE. The Minister for Health was appalled at this, frustrated. You'd swear he was one of the lawyers for the women, and not the minister in charge of the HSE.

The trouble with all this, and the trouble with us pesky Irish people is that we do look under the bonnet, and we have a media that looks under the bonnet, and we have difficult men and women who just won't go away. And all the navy suits and calming tones in the world won't bamboozle us.

And as much as the economy is flying, and Leo is popular, issues like housing and the seeming omnishambles that is the health service, and a sanctuary for suicidal young people that has a wire shaped like a noose hanging loose there, are noises that are going to get louder and louder as we zero in on an election.

Sunday Independent

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