Mental Illness 2012

Issue raised by Dan Neville TD on Discrimination of Mental Illness and Suicide

Dáil Éireann; 11th December 2012

Deputy Dan Neville

I thank the Ceann Comhairle for allowing me to raise this very important issue regarding the treatment of and discrimination against those who suffer from mental health conditions and the families of those who have completed suicide. It involves the use of negative labels to identify people with mental health problems and has its roots in fear and misunderstanding. Many hold negative opinions towards people with mental health problems because they do not understand the issues involved and rely on myths and misconceptions. The core issues arising from social stigma are that in general people have little understanding of mental health problems and much of the information they have is factually incorrect. Anxiety, fear and avoidance are common feelings experienced by people with mental health problems and discrimination is imposed on them. People with mental health difficulties must enjoy the same rights on an equal basis with all others in society.

Stigma can be deeply hurtful and isolating and is one of the most significant problems encountered by people with a mental illness. Learning to live with mental health problems is made more difficult when somebody experiences the prejudice caused by stigma which can be used to exclude and marginalise. The prejudice and fear caused by stigma may and does prevent people from coming forward to seek the help they need. It can also frustrate those who look for improvements in mental health services because the stigma prevents those affected from demanding that proper services be made available. It can also stop people offering help or being supportive, inhibit people in getting the jobs they are qualified to do and prevent people with mental health problems from playing an active role in the community.

The See Change programme introduced by the previous Government is a targeted programme under which excellent work is done but much more needs to be done. The Minister of State might outline the budget for next year and the projected outcome this year of the programme which campaigns for the promotion of understanding of mental health issues and a reduction of the stigma attached. It does this through a targeted, community-driven approach and has the potential to effect change within society and help to lay the necessary foundations for a real and positive transformation of how mental health problems are perceived.

St. Patrick’s Hospital published the findings of a survey in September which showed people tended to understate the level of stigma, given the fact that many who respond to such surveys do not want to admit to holding negative views. Over 20% of those surveyed believed those with mental health problems were of below average intelligence; 40% considered seeking help for a mental health problem to be a sign of personal failure; 66% experienced a reluctance to hire a person with a history of mental illness, believing him or her to be unreliable; while 30% said they would not be willing to accept someone with a mental health problem as a close friend. Amnesty International found in its research that 94% of those who suffered from a mental health problem had experienced unfair treatment; 70% concealed mental health problems; 50% had stopped having close relationships; 60% had stopped working; and 40% had stopped engaging in education. This is an indication of the level of stigma in society towards those with mental health problems.

Deputy Alex White (Minister of State at the Department of Health)

I thank the Deputy for raising this important issue. Learning to live with mental health problems is extremely difficult, but, as the Deputy said, this difficulty can be compounded when someone experiences, at first hand, the prejudice caused by stigma. We know the stigma attached to mental ill health and suicidal behaviour presents one of the biggest challenges to prevention and that it encourages intolerance and prejudice. Stigma can affect all aspects of life, limiting access to employment and housing, harming social relationships and reducing self-esteem. Fear of being labelled as having a mental health problem also reduces the likelihood that individuals with mental health difficulties will seek treatment. The national stigma reduction campaign, See Change, launched in 2010 is working to change these attitudes in order that every person in Ireland can be positive about his or her mental health problems. The target groups identified in the first phase of the campaign include young males aged 18 to 24 years, people in the workplace and farmers and individuals living in rural communities.

To build on its baseline research conducted for the campaign in 2010, See Change recently commissioned Millward Brown Lansdowne to carry out a nationally representative survey of Irish attitudes towards mental health problems. The findings of this survey show there is an increased willingness to seek professional help and that an increased number of Irish people admit to having some experience of mental health problems, either themselves or through others. The survey also found there was increased awareness and understanding of mental health, mental health problems, stigma and support services. However, it also found there was a greater reluctance to be open and disclose information on a mental health problem in personal and professional relationships.

For its part, the HSE, through the National Office for Suicide Prevention, co-ordinates two national mental health awareness campaigns, the Your Mental Health campaign and the Let Someone Know campaign, which have been shown to be effective in changing the population’s knowledge and attitudes to mental health and encouraging people to talk about their mental health and well-being. In challenging the stigma associated with suicide and mental health issues the language used by the media is also hugely important. Headline is Ireland’s national media monitoring programme which is working to promote responsible and accurate coverage of mental health and suicide related issues within the media. It aims to highlight mental health issues and address the stigma attached to emotional distress, suicidal behaviour and mental illness through the promotion of responsible media coverage.

Eliminating stigma is not going to happen overnight. Reducing it was one of the priorities identified in the programme for Government. I reiterate the commitment of the Government and, in particular, the Minister of State, Deputy Kathleen Lynch, to promoting change in attitudes to mental ill health and ensuring people in distress do not feel isolated and alone.

Deputy Dan Neville

I thank the Minister of State for his reply. I agree with him that language is very important in how we address the issue. For example, how does a person with a mental health condition feel when he or she is referred to as a madman, barmy, off the wall or a nutcase? All of these terms stigmatise and the same is true when it comes to suicide. To say someone had “committed” suicide can be very upsetting for some of the bereaved because it is no longer a crime or a sin, although it never was a sin under the test applied by the churches. As one does not commit either a sin or a crime, why do we still use the word “commit”?

I welcome the announcement that the €35 million promised by the Government on an annual basis to develop community mental health teams and improve services, as outlined in A Vision for Change, will be ring-fenced again next year. This may have been missed in the aftermath of the budget.

I commend the Minister of State, Deputy Kathleen Lynch, on her success in ensuring that this particular Government commitment was honoured in 2012. In regard to the commitment to approve the filling of 414 posts in 2012 for the purposes of implementing objectives under the €35 million funding programme, I understand that 17 posts have been filled to date and 270 offers of employment have been accepted. Those appointments are proceeding and staff are expected to commence work this month. It seems clear, however, that the full allocation of €35 million cannot have been spent because the staff were not in place in time. Will the Minister of State indicate the status of the funding which was not spent as a consequence of this delay? I accept that such delays may arise, but the question is whether these particular moneys were transferred to other areas within the mental health sector or were instead moved out to other sectors of the broader health service.

Deputy Alex White

I thank the Deputy for giving us the benefit of his knowledge and insight on this issue. His point regarding the importance of language is well made. I agree fully that care must be exercised in this regard, even in respect of the individual words and phrases used to describe particular situations. At the same time, we must take on board the reluctance people sometimes feel when it comes to articulating their views and experiences in this area. As such, our efforts to exercise caution in the language we use and to urge others to do the same should not go so far that they run the risk of shutting down any type of discussion. In other words, taking care about the language and expressions we use must not prevent us from having a sufficiently frank and open debate, whether in this House, in the media or elsewhere. Having said that, I very much take the Deputy’s point regarding the great hurt that can be caused when factual misunderstandings and so on arise.

I thank the Deputy for his acknowledgment that the allocation of €35 million for measures set out in A Vision for Change will be maintained next year, notwithstanding the very considerable demands on the funding of mental health services. I am pleased to confirm that this funding, ring-fenced as it is for 2013, will be of enormous benefit in terms of achieving our objectives in this area, objectives that the Government shares with the Deputy.