There is not a single family across this island that has not been affected by the challenge of mental health issues. It is now accepted that one in seven adults will experience mental health challenges in any given year and that the real figures for suicide across the island of Ireland are as high as 1,000 people annually.

I want to ask the Tánaiste about the Mental Health Commission's annual report which was published on Monday. The State's mental health policy, A Vision for Change, has been in place since 2006 and the Mental Health Commission has undertaken a strategic review as part of developing a new strategic plan for 2016-2018. The commission's report illustrates how much remains to be done. This includes a need for independent monitoring of the A Vision for Change policy. Given that the policy is ten years old and allowing for increases in population and other demographic changes, I imagine the Tánaiste agrees that this is very urgently needed.

There are also significant issues around funding or the lack of funding. The current level of funding for mental health is still less than the 8.24% target based on the 2005 figures envisaged in A Vision for Change. The staffing levels are about 75% of the A Vision for Change recommended number. According to the Mental Health Commission's report, there is a serious deficiency in the development and provision of recovery oriented mental health services. This concept, which is about aiding a person's recovery rather than managing the illness, is crucial. The report states that the reason for this is the combined effect of poor manpower planning, lack of change in professional training schemes, cuts in public expenditure, delays in recruitment and a shortage of appropriately trained staff.

I do not have the time to go through all of the report's details but I would like to raise some very specific issues. One issue is 24-hour staffed community residences. The commission remains concerned that some of these are too large, have poor physical infrastructure, are institutional in nature and lack individual care plans. It goes on to say, which is very alarming, that there is a fundamental issue of identifying precisely the number of residences and people living in them. In other words, we do not know. This is an alarming revelation. The commission also expresses concern about the admission of children to adult services. In 2015, some 95 children were admitted to adult units. I am sure the Tánaiste will agree that this is totally unacceptable.

The Government has yet to introduce draft legislation to bring about the changes envisaged in the review of the Mental Health Act 2001 which was published in December 2014. My question is straightforward. Does the Tánaiste accept that the Government has to act on the findings of this report?

I accept that the whole area of mental health needs ongoing investment which we need to prioritise. I hope the health committee will prioritise a discussion of the full implementation of A Vision for Change, which also needs a review. The report that Deputy Adams referenced, the Mental Health Commission annual report of 2015, reflects the very widely accepted need to develop further a complete community-based mental health service with a prevention and recovery focus. I am sure there is no one in this House who does not agree with what the Deputy says about the need for priority focus and ongoing improvement and investment in the whole mental health area. Thankfully, we have seen changes and we have seen the move from residential to community care but unfortunately the economic situation impacted on the development and implementation of A Vision for Change. What we have to do now, given that we have the resources available, is make sure we accelerate funding in this area. That is what the Government has done. We are committed to providing additional resources in this area. If one looks at the recent Government decision to allocate an extra €500 million to the health area, that involved an increase in mental health funding from €785 million in 2015 to a projected budget of €826 million in 2016, which represents an increase of €41 million or 5.2%. That funding is very important.

The recruitment of front-line staff has been difficult but needs to continue and vacancies are being advertised as I speak. Hopefully that will begin to build up the complement of posts that are necessary. Up to 1,150 posts have been filled up to the end of 2015, with 270 posts approved for the child and adolescent services, which also need development and staff.

A number of priority development areas have already been identified that will be ongoing this year. They include the improved counselling services and the provision of three new Jigsaw centres, which are extremely important to young people in local communities. I am sure Deputy Adams will agree that the provision of those extra centres will be important, particularly for the more vulnerable children in areas across the country.

Deputy Adams made a point about children who were admitted to adult psychiatric units. Indeed, it is shameful that we continue to have such a situation, even though it has significantly changed, from more than 200 children being admitted to adult inpatient psychiatric units down to 95 last year. Every one of those is one too many and we must accelerate our efforts. There is increased funding and it will begin to deal with the issues I have identified in a more comprehensive way. The Minister of State, Deputy McEntee, is determined to have a strong priority focus on the mental health issues that Deputy Adams has identified and that we all know need continuing attention.

I, and other Teachtaí, have been raising these issues regularly and I do not minimise the challenges involved. I wish the Minister of State, Deputy McEntee, well. Sinn Féin will co-operate with her in dealing with this crucially important issue. In fact, the leasuachtarán of Sinn Féin, an Teachta Mary Lou McDonald, has national responsibility for our mental health and suicide prevention portfolio. I believe firmly that an all-party and all-island approach is required and there should be full co-operation with our colleagues in the North. I have long argued for an all-island suicide prevention strategy and for a campaign similar to that undertaken by the Road Safety Authority. Although the Taoiseach has made positive responses to this over the years, this has yet to be put in place. I commend that approach to the Tánaiste and to the Minister of State.

I welcome the Tánaiste's assertion that mental health services need investment and I look to her to deliver on that. However, I do not accept that the recession played a part in underinvestment. It was Government decisions which led to under investment. In fact, an unfortunate insight into the Government's attitude was the fact that funding which was ring-fenced for mental health was used for other purposes.

I thank Deputy Adams.

That has been restored but this does not imbue confidence.

Another damning finding of the Mental Health Commission is that 10% of facilities inspected by it in 2015 were not compliant.

All right. I thank Deputy Adams.

I am asking the question, le do thoil.

Tá an t-am istigh.

When will the Government publish an implementation plan for the outstanding elements of A Vision for Change and when will we have an opportunity to discuss this here?

Regarding the compliance issue, six approved mental health centres achieved full compliance with all the regulatory requirements in 2015. While what Deputy Adams says is true that other centres were non-compliant to varying degrees, I am advised that, given the nature of the requirements where centres were non-compliant, the potential for full compliance is strong. Certainly, the Minister of State, Deputy McEntee, has urged the maximum effort on the part of all of those non-compliant centres to meet the requirements. It is important that we have such inspection and that there is a continuous monitoring of the implementation of the inspectorate regime.

Regarding Deputy Adams's point about North-South co-operation, when I was the Minister for Children and Youth Affairs, I was involved in North-South meetings and the topic of mental health was discussed and various North-South initiatives were considered. I agree with Deputy Adams that collaboration and best practice models need to be exchanged, North-South. I believe that has happened. Perhaps it could happen more but that certainly was on the agenda at some of the meetings I attended.

Deputy Catherine Connolly is representing Independents 4 Change.

Following up on the same topic, the ten-year strategy published in 2006 set out a comprehensive model of mental health. It gave a framework for building and fostering mental health across the entire community and providing accessible community-based specialist service for those with mental illness. In other words, it told the Government back in 2006 what to do, more importantly, how to do it and, even more importantly, in the knowledge that any government might not do it, made a strong recommendation that a monitoring body be set up. That monitoring body was set up. It was set up for two three-year periods, between 2006 and 2009 and between 2009 and 2012.

Significantly, it was disbanded for some reason, so we have no independent monitoring group, as per A Vision for Change. When it sat, the monitoring group and the Mental Health Commission repeatedly pointed out that the implementation of A Vision for Change has been slow and inconsistent. This week, the Mental Health Commission again confirms that A Vision for Change is extremely important and puts the patient at the core in terms of recovery. However, it points out that much needs to be done. Additionally, it points out a serious number of failures and issues to be rectified, with the first being the setting up of an independent monitoring commission. That has not been done and I would like the Tánaiste's answer on that. The second issue is an immediate review. Since coming to the Dáil I have heard statement after statement being made with goodwill. There is no answer from the Government as to when the review will be set up, who sits on the panel and when there will be a review report.

Some of the specific issues highlighted by the Mental Health Commission have already been mentioned. Although I am paraphrasing the Tánaiste, it is not appropriate for her to say they are not that bad. There are serious problems, notwithstanding the good work of the staff. Of the 61 inspections, only six facilities were fully compliant and only one of those was run by the Health Service Executive. Well done to that centre in Ballinasloe in east Galway. There were 95 children admitted to the wrong facility. In 1997, the European Commission of Human Rights indicated that we were failing to comply with our obligations by not providing appropriate facilities. We are doing the same thing 19 years later. Spending on mental health was as high as 14% of the budget in the 1990s, when we had very little money, but it is now down to 6%. A Vision for Change specifically asked for a figure of at least 8.2%.

With regard to improvements in the economy, it costs more not to deal with mental health. On page 176 of A Vision for Change from 2006, it is stated that the cost of a failure to deal with mental health issues is €11 billion. I believe that figure is wrong, but it is in the document. Will the Tánaiste answer those two specific questions?

I spoke about the importance of compliance and I certainly accept what the Deputy says about it. I did not mean to suggest in any way that the issues of the other centres which have not met full compliance were in any way insignificant. The point I made is that the potential for full compliance is certainly there. That is what the Minister of State will be pursuing with respect to the points made in that report. I have no doubt she will be addressing the range of recommendations in the report, including the question of monitoring. I do not have a specific date but I have no doubt it will be an important part of her consideration with regard to the implementation of the recommendations.

A full policy review in the area has been announced by the Minister of State, which is important. Everybody accepts there have been major changes in how we deal with mental health in this country. I am thankful that the stigma that was there has certainly changed, and I notice this very much among young people. We know issues remain and we need a more concerted effort across all society to ensure people get the kind of help they need with mental health difficulties at an early stage. The help, in the first instance, should be in the community, with inpatient facilities as needed.

There is a full chapter in the programme for Government on mental health and commitments on a variety of issues that have come to people's attention in recent years, including access to a GP and other mental health services in primary care, which is extremely important. A Vision for Change was accepted very much as a roadmap to improved mental health services. We now have the funding, which had, unfortunately, decreased at a time when there was little choice in the matter because of the cycle of boom and bust economy. I am thankful we are now in a position to reinvest in the area, and the Government has demonstrated its commitment to investment in the health services with the announcement of €500 million in extra funding just two weeks ago.

A proportion of that is for mental health services. There is also a commitment in the programme for Government to review this annually and to have increased investment in mental health services. The issues Deputy Connolly has raised will get the attention they deserve and I have no doubt that the Minister of State, Deputy McEntee, will be making a statement on the report.

I thank the Minister for her reply but I do not think her reassurances are good enough at this stage. She has an obligation, as does the Government, to reinstate the implementation body. It was part of A Vision for Change, so she is not complying with her duty of care under that strategy. She has failed to tell me why it was disbanded and why it has not been reintroduced.

In respect of the review, this has been mentioned continually and yet no date has been given. I specifically asked what date the review started, when it will be finished and who sits on the review panel. A Vision for Change was a ten-year strategy, which finished last January. We are now in June and we still have no mention of the review and no date for it. The blueprint was written back in 2006. It had a chapter on suicide. In 2006, the incidence of suicide was at crisis levels. We do not need statements on how it should be done; it is all there. We need confirmation on how that report is going to be updated, reviewed and implemented. It will save the economy money, so saying the Government does not have money or did not have money is not an explanation. It is actually costing the economy more to do nothing.

I have made very clear in my reply to the Deputy that this is a priority issue for Government. I recognise her passion for this issue and it is shared by all of us. It is a priority issue, we are investing in this area and I will ask the Minister of State to communicate with the Deputy directly in respect of the specific points she raised about the timeframe for the review and why the original monitoring committee did not continue. It may have been time-limited. I do not have that information right now but I will ask the Minister of State to liaise directly with the Deputy in respect of the questions she raised.