There is a mental health and suicide crisis in Wexford. Everyone does not present with suicidal ideation, and it is not always possible to identify signs that someone might be suicidal, but there seems to be an incredible lack of an emergency response to those who do so.

Kenneth Rowe took his own life just over one year ago at the age of 32. Before Christmas, I read a letter from Kenneth's sister in this Chamber and I shall repeat one line from it:

Imagine our despair that in spite of an urgent referral from Waterford to Summerhill Community Mental Health Services, [Wexford] Kenneth’s appointment was for six weeks later. The wait was impossible ... Kenneth fought so hard to stay alive for everyone and everything he loved. But he didn’t make it. He ended his life 19 days before his appointment at Summerhill.

I have spoken to the parents of a number of children who have presented with suicidal ideation and who have had to wait for more than two and half years to get the supports they have needed from the child and adolescent mental health service, CAMHS. Dr. Kieran Moore resigned from his position as consultant child psychiatrist almost one year ago and we still do not have a replacement. Anne O'Connor, the national director of mental health services in the HSE said in 2017 that CAMHS had become a catch-all service in the absence of other services. It was never designed to be a catch-all service but to cater for children and adolescents with severe and enduring mental health illnesses. Children who do not need to be are funnelled into CAMHS because alternatives are not there. Anne O'Connor said that young people should be able to go to their GPs in order to get access to a primary care-based psychology or family counselling service. The waiting time for primary care child psychology services in Wexford is more than three years. This is despite the fact that four newly created assistant psychologist positions were filled in the last year in Wexford. A three-year wait is hardly good enough.

In its final report, the Joint Committee on Future of Mental Health Care expressed serious concerns at "the lack of accessible counselling services and [that] the money spent by the State on the services is insufficient, as compared to expenditure on psychotropic medication." The report also states, "Evidence also supports that there is an over reliance on medication as a response to preventing 'mental ill health' issues in the absence of alternatives in primary, community care levels." The Ombudsman for Children informed the committee that children have identified a rush to medicate in their treatment, which is incredible.

The lack of adequate community and primary care mental health services in Wexford is a serious problem. The pace of change is painfully slow. It is too slow for some. Kenneth Rowe was one of those. I realise that suicide figures nationally are down but they are still incredibly high in Wexford and it is one of the most concerning issues in the county. Do we need more resources? Do we need a different approach? I know it is not easy but I put it to the Taoiseach that whatever it is we are doing, it does not seem to be good enough.

I thank the Deputy. I am very sorry to hear about that gentleman and his experience. I am aware that Deputy Wallace raised the matter in the House previously. I doubt that any Deputy has not in some way been affected by suicide or does not know someone who has taken his or her own life. We all know the enormous grief this causes and the effect it has on families and friends. It is a grief that never dies; it goes on forever. As Deputy Wallace stated, this is an area in which there has been some progress in recent years. The number of people in Ireland taking their lives has decreased by 30% since 2012. Suicide rates in Ireland are now roughly at the EU norm. Statistics such as this mean nothing to anybody who has had suicide touch his or her life. I acknowledge that it does vary from place to place within the State, but I do not have that particular breakdown in front of me.

In the context of what it can do, the Government is committed to developing mental health services in the broadest sense, namely, for the health service and for education in the context of well-being and resilience, which are very important. The budget for mental health will approach €1 billion, which is very large and which is acknowledged by experts, such as Senator Freeman, as being more than is spent in many other similar countries. It provides an additional €55 million for the development of services in 2019. We need to make sure this money gets to the patients and to those who need it most.

There are 2,560 children on the CAMHS waiting list. The HSE is prioritising those who are waiting more than 12 months, which is some 295 children. All aspects of CAMHS will be improved as part of the service plan in 2019. This will include: better out of hours cover and 7-7 cover where possible; progression of day hospital care; development of specialist teams, for example for eating disorders; and improved prevention and early interventions. There are now 70 CAMHS teams and three paediatric liaison teams. The Minister of State, Deputy Jim Daly, who is the lead Minster for this matter and on issues of mental health, will meet the HSE on 23 January to review progress on all aspects of CAMHS, including waiting lists. I will ask him to raise Wexford as a particular black spot when it comes to these matters. We now have 114 assistant psychologists hired and 20 psychologists recruited for the primary care services. These were recruited throughout the course of last year. We hope that the full year effect of them being employed now will make a difference in waiting times.

Some 2,500 people were referred to counselling in primary care in 2016 and 2017 in community health organisation, CHO, 5. Some 950 people were referred to the self-harm intervention counselling programme in the same years. I asked the HSE for the numbers of people being prescribed antidepressant medication for those same years. It gave me the numbers of 249,500 people in 2015 and 390,000 for 2016. This is just the data of those who use medical cards and it represents a 36% increase. We know that medication can be helpful but the number of people on antidepressants is totally out of sync when compared to the numbers who receive counselling. Any psychiatrist who believes in the idea of recovery will tell us that antidepressants are not intended to be used as a long-term solution and are damaging when taken in the absence of ongoing counselling or talking therapies. In Ireland, however, there are 250,000 people - medical card holders - on antidepressants and perhaps only one in ten is talking to anyone about the root of his or her problems. It is a recipe for drug dependence and it does not lead to a great deal in terms of recovery.

The people in Wexford desperately want things to be different. Kenneth Rowe's family have spoken about the lack of talk therapy offered to him. He was put on powerful antidepressants. On 2 January 2018 his prescription was doubled and his agitation became extremely intense. He was dead three days later. We will never know if talk therapy would have saved him but we owe it to him and to others to make real change to the way we provide mental healthcare in this State. It is not good enough.

It is important to state that medicines - antidepressants, anxiolytics and anti-psychotics - have a role to play in the treatment of mental illness. I know the Deputy is not disputing that and does not disagree with it. When these medicines are prescribed, it is by general practitioners or psychiatrists. I am sure that in the vast majority of cases when these medicines are prescribed, this is the appropriate course of action. I also acknowledge the Deputy's point to the effect that it is much easier for a doctor to prescribe medicine that a patient can get within hours than it is to get counselling, cognitive behavioural therapy or talk therapy for him or her. The doctor can sign the prescription, give it to the patient and the patient can be in the pharmacy within the hour and have his or her medicine. It takes much longer for patients to get access to other treatments such as behavioural therapies and counselling and all those things that we know also have an effect. The Deputy makes a fair point.

The Minister of State, Deputy Jim Daly, is here and he has informed me that he is going to meet the CAMHS teams' management and clinical leads next Wednesday, as well as senior HSE management. Deputy Wallace is aware there is €55 million available to make meaningful improvements in mental health in the year ahead. The challenge the Government always faces is to ensure that money gets to the patients. If it works, we should see more people getting access to those therapies more quickly and, perhaps as a result of that, a fall in the number of prescriptions and in medication costs.