Táim ag díriú isteach inniu ag leibhéal Ceisteanna ó Cheannairí ar chúrsaí meabhairshláinte, mar atá déanta agam le breis agus ceithre bliana anuas. Tagraím go háirithe don bhearna atá ann ó thaobh easpa córas monatóireachta neamhspleách san earnáil seo. I could read out the question I raised in December 2019 and all other questions I have raised at the level of Taoiseach on mental health and the absence of services. I have a specific question today and we could save a lot of time if the Taoiseach could just answer it. It is on the urgent need for an independent monitoring body to implement what was A Vision for Change and is now Sharing the Vision: A Mental Health Service for Everyone. If the Taoiseach tells me he is taking this seriously and urgently, gives me a date for its implementation and assures me there will be a broad range of therapists and therapies represented on it, I will thank him and look forward to working with him.

In 1984, the document, Planning for the Future, confirmed our mental health services were not fit for purpose. It showed the way forward. It took until 2006 to get another document, which was A Vision for Change. It is a wonderful document and there is no need to change it, only to update it, as we have had done. Theoretically, it ran out in January 2016. Then we had a review of the literature, which took a few weeks and then months to publish. Then it took another four years of pressure from me and other Deputies from all parties to ask for the publication of the new document, which is Sharing the Vision: A Mental Health Service for Everyone. During all this time, the mental health service is absolutely creaking at the seams.

In Galway over the past few days, at an informal social gathering, I became aware of three suicides in a very short period involving people aged between 15 to 70. We know that hospitals have stopped gathering data on suicides and we have no up-to-date figures. We also know that, in a very short period, 17% of patients admitted to the national spinal injuries unit at the Mater hospital had injuries associated with attempted suicide and there are many other anecdotes and stories. At this point, I do not wish to go into any of them. For four and a half years we have had statements on mental health. I do not want any more statements. Nobody in the psychology or psychiatric fields trusts any Government. They do not trust any politician, including myself, and I accept that. This is why there is a need for an independent monitoring body. To show the Taoiseach's bona fides, let us stop the talking and the statements and confirm that will be set up as a matter of urgency before the end of August.

Admhaím go bhfuil feachtas pearsanta á rith ag an Teachta maidir leis an gceist seo agus go bhfuil sí ag obair go dian dícheallach ar son daoine atá ag baint seirbhís síos ón tseirbhís sláinte. Aontaím leis an chuid is mó de céard atá ráite aici. Táim taobh thiar de straitéis na Roinne agus laistigh de sin, táim taobh thiar den phlean chun bord neamhspleách a chur i bhfeidhm chun scrúdú a dhéanamh ar pholasaithe agus dul chun cinn polasaithe Sharing the Vision.

A national implementation and monitoring body or commission should be established. The Mental Health Commission is such a body, which I established myself legislatively quite some time ago. It has always had an independent approach, which is the ideal approach to mental health services, but I take the Deputy's point that it is more on the side of regulating and monitoring existing services with regard to whether they are in conformity with the law. It seems to me that funding has not been an issue for mental health in recent years but the identification and recruitment of qualified personnel seems to have been an issue that has bedevilled the health service and that the health service has found it very difficult to deal with in psychiatry, and child and adolescent psychiatry in particular and dealing with young people.

In discussing this with regard to the programme for Government, we said we have to utilise the NGO and voluntary sectors in tandem and try to integrate them with the statutory services and, perhaps, develop a broader canvas in the utilisation of psychologists, therapists and multidisciplinary teams. My personal view is the more we can situate mental health services in the community, with access to local multidisciplinary teams, the more effective the outcomes will be.

A barometer of success is having less of a need for acute services. There will always be a need for acute services but if they are full or have high occupancy it is reflective of a dearth of resources and productivity in community care. This is the philosophy we should work towards and make sure there is wide provision. I will go back to the Minister for Health and come back to the Deputy on the establishment of a national independent body to oversee the implementation of Sharing the Vision: A Mental Health Policy for Everyone.

I have been monitoring this over the last two to three years in the context of the confidence and supply agreement in which we put a priority on mental health, but all we heard back from the health service was about an inability to recruit psychiatrists and personnel for the child and adolescent services and hence an ongoing lack of key personnel.

What has bedevilled mental health services is that language does not mean anything. I have asked for confirmation of when the independent monitoring body will be established. The Mental Health Commission has a completely different function. Indeed, when it produced its annual report it was absolutely damning regarding the absence of specific treatment plans, care plans, unsuitable buildings and so forth. My opinion and the Taoiseach's opinion do not matter anymore. We have had A Vision for Change, Sharing the Vision: a Mental Health Policy for Everyone and Planning for the Future. The common denominator in all of that is the move out of the institutions. We are beyond that. The common denominator is that we must have an independent monitoring body. That body sat for two three-year periods and it did such a good job that the Government abolished it. At this point, the Government must re-establish the independent monitoring body, and let statements in the Dáil be about whether that body is doing its job or not and what resources it needs to do it.

There are delayed discharges in Galway city. The last time I checked there were four, which means four people were in psychiatric units who should not have been there. Any Deputy here can add to this. I am asking for an independent monitoring body. On what date will it be set up with a broad range of therapists' representatives on it?

I do not have a date for that right now, but I indicated to the Deputy that I will support its establishment and talk to the Minister for Health about it. Equally, I believe the Deputy's voice matters. Every Deputy's voice matters. We have to keep at this. We can set up the independent implementation monitoring body to monitor the implementation of this, but we cannot be blind to certain constants in the mental health service. There have been certain positives as well that must be acknowledged. The establishment of the child and adolescent units was effective, in terms of the facilities and so forth, in reducing the number of children and teenagers in adult facilities, although there are still too many. When no child is in an adult facility we will be satisfied. There has been some progress, but the problem has been the recruitment of personnel, including in the child and adolescent services. We must tackle that collectively, and if we do not get particular personnel we must work on alternatives to that. There is no point in keeping our heads in the sand either and just passing it over to some independent implementation body. This must be ongoing. The recruitment of key personnel is a problem that is not going away. That is where I wish to focus our attention, in terms of ensuring we can fill the gaps in the service at present which are leaving the people who need the services short.

That concludes Leaders' Questions. We will proceed to the Order of Business.