Finance Bill 2010 — Dail Debate on 10th January 2010 — Speech by Dan Neville TD
I am deeply disappointed with the Finance Bill 2010 which does not recognise the crisis in society, due in part to the recession, in respect of mental well-being, in particular depression caused by the situation that has developed.
In general, I am disappointed that the Bill and budget did not respond to the needs, expressed for a number of years, in terms of under-funding of the psychiatric services. Some 6.7% of the total health budget is now allocated to psychiatric services. The figure for England and Wales is 13% and for Scotland 18%. We have neglected our mental health services and it is extremely disappointing that the Bill and the budget ignored the glaring need to respond to this issue.
Long-term psychiatric patients are living in Dickensian-type accommodation. The inspector of mental services, who recently spoke about particular institutions, has expressed horror in respect of the conditions in this regard. For as long as I have been a Member of the Oireachtas, now almost 21 years, there have been promises of funding in this area. However, during that period the total budget for the psychiatric service in terms of the overall health budget has been decreasing. Time and again we have spoken about this issue to no avail. I take this opportunity to remind the Government that it has again ignored this crucial societal and medical issue. People are entitled to modern conditions and facilities and to a response to the recommendations of the mental health services report entitled A Vision for Change which was accepted by Government four years ago. Despite the firm commitments made by Government these problems have not been fully resolved and the recommendations have not been fully implemented.
Moneys allocated two years ago by the Minister for Health and Children for the improvement of mental health services was syphoned off into the health budget. For the following two years, this was used as an excuse not to provide further funding to the mental health services. The Minister for Health and Children asked at a committee meeting why she should give money to the Health Service Executive to address mental health service issues when it will not use it for that purpose. I wonder who is in charge. The urgency with which this issue must be addressed in times of the recession is again highlighted in significant deterioration in the area of mental health. A report published last year indicated that more than 50% of respondents were going without food and heating.
I turn now to deal with problem debt, which is a real issue for many people in our society.
At present, debt is a real issue for many people who may never have experienced such problems in the past. Of those who had debt problems, 71% ran out of money every week or most weeks, 87% relied on credit to pay for food and everyday costs, 56% went without food due to debt, 21% went without heating and 92% reported not being able to socialise. The research also found that people with mental health problems are three times more likely to be in debt as they are living on a low income and unable to work due to difficulties getting a job because of the stigma or due to ill health.
One of the challenges facing society, and in particular the Oireachtas and the Government, is to fund programmes to deal with psychiatric illness. Until we destigmatise it, society will not accept it as a normal illness, although that is what it is. People with psychiatric illness cannot help being ill, any more than those with a heart condition, influenza, diabetes or any other medical condition. In the case of depression, we know that with early intervention there is a 90% chance of achieving a full cure. People, and especially children, are not getting the opportunity to receive such intervention treatment.
It is important that debt collection agency staff receive mental health awareness training. Banks should adopt a system whereby customers can choose to have their account monitored for erratic spending to better protect their finances. Irish personal debt stands at a staggering €172 billion and is a significant cost on our mental health. Money worries are not just keeping people awake at night; they are causing high levels of stress, depression and in some cases self-harm and suicide. At a time when people across the country are anxious about their finances, debt depression is a real and growing concern.
People living with mental health problems are particularly vulnerable to being trapped in a cycle of debt and poverty with many unable to work due to ill health. People are becoming dependent on credit to pay for everyday essentials. Those on lower incomes are more likely to get credit from lenders who charge astronomical interest rates. It is a worrying trend as people are left facing a mountain of debt that they have no means of repaying.
If we are going to tackle this massive inequality and really help people who are struggling with mental health problems and debt, we need to see action by the Government, the HSE, banks, debt-collection agencies and other creditors. The Government must provide a lead in this respect. The Bill before us, however, has missed the opportunity to give such a lead. The budget missed this opportunity also in failing to allocate sufficient funds to a mental health service, which is totally underfunded.
Changes in practice, such as waiving fees when a customer has been unwell and introducing mental health awareness training for bank staff, would make all the difference. Creditors have a duty to help and not hound their customers, especially when they are coping with serious health problems.
People with bipolar disorder, which can cause sufferers to spend extravagantly during a manic phase or schizophrenia, are four times more likely to be in debt than the rest of society. According to the survey to which I referred earlier, fewer than one in three people with problem debt informed the organisation to which they owed money of their mental health problems because they did not think that they would be understood or believed. Some 83% of those who did tell creditors continued to be harassed about their debt payments. The Government must give leadership in this area and ensure that resources are available to psychiatric services to deal with this fallout from the current economic crisis.
An issue that has arisen in the past two weeks concerns the release from the Central Statistics Office of suicide levels for the first half of 2009. The Government must address the emergency that has arisen concerning these suicide rates. The latest figures from the Central Statistics Office show the number of deaths by suicide increased by 35% in the first half of 2009. Some 228 people took their own lives in the first half of last year, compared to 169 in the same period in 2008. The Government must pay heed to the link between recession, unemployment and suicide.
It is alarming that the Government has not responded to this emergency, although it is aware of it. As I said earlier, the Government responded inadequately to flooding before Christmas and to the big freeze-up after Christmas. It must now respond adequately to the suicide emergency.
Figures for the second quarter of 2009 show that there were 122 deaths by suicide in that period, which is an increase from 95 deaths by suicide in the second quarter of 2008. Taken with the first quarter figures for 2009, this shows that over the first half of last year 228 people took their own lives, an increase of 35% on the first half of 2008. Some 77% of the deaths by suicide were among men, while 40% of those who took their own lives were under 35 years of age. This, therefore, is a young person’s problem facing those who have a lot of potential and much to contribute. We must bear in mind the trauma that suicide causes to the bereaved families and relatives. The Government should regard an increase of the magnitude of 35% in the number of suicides as warranting an emergency response.
The link between suicide and financial disaster has been well established. Unemployment, insecure employment, threat to or loss of home and restricted access to credit take a heavy psychological toll on public health. There is a reduction in mental well-being and an increase in mental health problems, substance misuse, relationship breakdown and divorce.
During recessionary times, there is a sudden gap between material needs and resources. In economic downturns, frustration increases as an increasing proportion of people cannot realise their financial goals. This frustration can increase aggression, including suicide.
Research published in 1967 found that the absolute value of change in stock market prices was associated with an increase in male suicide rates from 1929 to 1940. This confirmed the position that economic change downwards in the business cycle increases suicide. In earlier studies the rate of unemployment emerged as the leading predictor of suicide rates. There have been numerous studies of this type over the years. Most continue to illustrate a clear link between unemployment and suicide rates. This is true especially for males. All studies show higher rates of ill health, both psychological and physical, in men and women who are in insecure work or are unemployed. A protracted period of unemployment of people at a young age seems to have a particularly deleterious effect on the mental health of young men, regardless of their social background.
Unemployment affects the suicide rate and has a profound effect on a person, especially on the young and on those in middle age. Irish society awards status and prestige according to a person’s position and contribution to work. Unemployment is associated with loss of face and of prestige. The unemployed are six times more likely to be suffering from a psychiatric disorder than those in employment, and they are three to four times more likely to take their own lives.