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Monday 4 December 2023 Dublin: 5°C
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The over-emphasis on medication over therapy is just one problem that needs fixing

Before the 2011 election, Taoiseach Enda Kenny singled out mental health as the key issue he wanted to tackle.

NEVER BEFORE IN the history of the Irish state has there been an opportunity like this to make mental health a priority for the people of Ireland. We have come from an era of stigma against mental health difficulties to an age where, for the first time, people can talk about their mental distress openly.

People are more willing to seek mental health support than ever before, and that is very welcome.

But the legacy of decades of neglect, combined with increased demand, has left a mental health system cracking under pressure. The HSE has been struggling to recruit new staff, leading in the worst case to the closure of services for children and adolescents and for older people in some locations.

Letters being sent back unopened 

Since September, the HSE’s mental health service for older people in Donegal has been returning referral letters unopened due to the lack of a Consultant Psychiatrist. Earlier in the year, the child and adolescent service in Waterford was closed to new referrals and is now only re-opened courtesy of a temporary appointment.

shutterstock_265901390 Shutterstock / Shutterstock / /

For most of this year, children were still being admitted to adult wards. And still today, families seeking help in a crisis outside of office hours may be left to wait 8 hours or more in A&E. While the staff in mental health services continue to provide support to thousands of people in distress every year, the system is unsustainable with resources running 22% below recommended levels.

How has it gotten to this state? Before the 2011 election, Taoiseach Enda Kenny singled out mental health as the key issue he wanted to tackle, if elected. The Government has delivered on some of its commitments. Successive budgets since 2012 have included allocations to mental health care, although delays in expenditure mean that the HSE has yet to realise the full funding available.

The Mental Health Act 2001 has been reviewed in light of current human rights standards, and the Government has committed to drafting legislation that will give effect to its findings. There has been investment in mental health in primary care and now GPs can refer people with medical cards for counselling instead of having only medication to offer.

Years of underinvestment 

Despite these positive developments, however, the mental health services have not yet recovered from the many years of under-investment. The overwhelming message from people directly affected is still that change is needed, that good quality services are not yet available all across Ireland.

This year, people who use mental health services and their families have told Mental Health Reform about the shortfalls in meeting their needs: the over-emphasis on medication while not being offered talking therapies which could help them to recover, the lack of continuity in their care due to frequent changes in their treating doctor. One person described it as “a skeleton service that does not cater for the individual unless you fight for that attention.”

People who are going through mental or emotional distress deserve better; they deserve a real chance to recover and get back into a fulfilling life.

We, as a nation, have an opportunity in the coming weeks to make the mental wellbeing of the country a priority for the next Government. Each of us can remind candidates that mental health matters and ask for specific commitments that will improve the system. The #ourstateofmind campaign aims to give people who care about mental health the tools to do just that.

There are real steps that the next Government can take such as establishing a nationwide programme to build resilience in our children and young people; making sure that people in distress have access to 24/7 crisis supports, and prioritising easy access to counselling and psychological therapies for all people in difficulty so that early intervention can prevent longer-term difficulties.

Distressed poster

Mental Health Reform’s full Manifesto, available here, includes more actions and supporting evidence for what can work to improve the system.

What if mental health isn’t made a priority? What if it’s a case of business as usual? If we don’t raise our voices and cast our votes with mental health in mind, we will have missed a unique opportunity to push the next Government for firm commitments to continue the reform of Ireland’s mental health system. Supporting the mental wellbeing of the population is the best way to ensure Ireland’s recovery. Now is the time to let candidates know it.

Shari McDaid, PhD is the Director of Mental Health Reform. Follow their campaign here, using the #Ourstateofmind. You can follow her on Twitter at @ShariMcDaid.


  • Console  1800 247 247 – (suicide prevention, self-harm, bereavement)
  • Aware 1890 303 302 (depression, anxiety)
  • Pieta House 01 601 0000 or email - (suicide, self-harm)
  • Teen-Line Ireland 1800 833 634 (for ages 13 to 19)
  • Childline 1800 66 66 66 (for under 18s)

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