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Bressie has made this front page news, but how loud do we have to shout?

Twenty years ago, mental health wasn’t even a policy issue – it wasn’t even talked about, writes Dr Keith Gaynor.

Dr Keith Gaynor

TWENTY YEARS AGO, mental health did not exist as a public policy issue. It was a private tragedy, poorly funded and out of the way.

Through the bravery of many individual people telling their stories, mental health difficulties have begun to be recognised in Ireland as a normal part of health care. Difficult, but common and treatable, if the right services are available.

Unlike twenty years ago, it is now well known in Ireland that one in six people will have a mental health problem at any given time, that one quarter of the total burden of illness in Ireland is mental health related and that the Department of Health and Children estimates that mental health difficulties cost the Irish economy €11 billion annually.

Ordinary people have led the charge against mental health stigma in Ireland. Institutions and policy makers have lagged behind. However, there have been signs across the country that mental health is being seen as a societal issue and not just a personal one.

Mental health difficulties can affect anyone

Several politicians have spoken about how personally affected they were by the death of TD Shane McEntee in 2012 and how much this brought home to them the fact that mental health difficulties can affect anyone, at any time.

On a broader level, policy makers are beginning to understand that mental health is not a niche area of health.

Instead issues associated with mental health run through society. Many of the most complicated situations in education, justice, housing, the economy, social protection as well as physical health are co-related to mental health difficulties.

As an example, last year, the OECD, not a typical body to focus on health issues, highlighted the importance of mental health policy to employers.

If labour markets are to function well, it is important that policy makers address the interplay between mental health and work. They are slowly coming to recognise that they have long neglected an issue that is critical to people’s well-being and for contributing to sustainable economic growth.The policy changes required are substantial and involve a large number of institutions and stakeholders working towards better co-ordinated policies and service delivery. Reform will therefore require strong political leadership.The consolidated set of social, education, health, and labour market policy responses that are needed to promote better mental health and employment outcomes are the focus of this report.

In the last month, Bressie’s appearance at the Oireachtas Health Committee highlighted how mental health has become front page news and equally how much, at least on a personal level, politicians are keen to address it.

The First Fortnight Festival hosted a tremendous pre-election hustings, with members of every party speaking on their plans for mental health. The election manifesto by Mental Health Reform (#ourstateofmind) shows how achievable many improvements are in mental health, if there is a will to implement them.

Since there has been such a change in attitudes, why have services not improved?

Lobbying for change 

The missing piece is us. Ultimately, the policies that get prioritised are the ones the people lobby hardest for and feel the most passionately about. The Universal Social Charge (USC) has changed because Michael Noonan feels it will win him an election and he may well be right.

This is something people care about.

Bill Clinton had a very simple slogan to keep his team on focus during the 1992 election: “It’s the economy, stupid”. If this election is about the economy: growth vs austerity, if that is the primary focus of the voters, then every politician will follow.

However, for the first time in five years, we have the opportunity to set the agenda. We can say that Ireland needs more than a functioning economy, it needs a functioning society. A bedrock of a functioning society for young and old, rich and poor is good mental health.

If we can prioritise mental health in every tweet, to every canvasser, with every candidate, we can ensure that this is an issue that cannot be ignored. If one constituency seat is won or lost based on the candidate’s prioritisation of mental health, it is a message that will reverberate throughout the Oireachtas.

Politicians remember what wins votes. Mental health will become an issue that politicians will have to become knowledgeable about and campaign on, in the next election and the one after that.

Over the next couple of weeks our voices are extraordinarily strong. On a personal level, policy makers want change. Now on a political level, we have to make it happen.

Dr Keith Gaynor is a senior clinical psychologist in the outpatient department of St John of God Hospital, Stillorgan. He has just published his first book “Protecting Mental Health” (Veritas Press). 

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