Leaders' Questions

In view of the fact that Members will be here until late this evening, I appeal to them to keep to the time limits.

No issue is capturing the mood or the attention of our people, and especially our young people, more than mental health and suicide. It is causing enormous grief, devastation, fear, anxiety and worry. In the past two weeks in Cork, it is believed that up to 16 people have died by suicide. A multi-agency response has been organised and a task force is to meet next month to respond to the situation. The rate of suicide in the city and county of Cork is almost twice the national average and Ireland is fourth highest in the table of suicides among those aged between 15 and 19. Mental health campaigner Conor Cusack has called for the establishment of 24-7 emotional well-being centres in response to the carnage caused by this particular crisis. He correctly makes the point that it is not just a Government or health service issue but a whole-of-society issue and that we all share a responsibility to make a change. It is in that spirit that I raise the issue today. We in this House also have a responsibility and we should put party political differences to one side and think outside the box so that we cannot just send the right signals on this issue, but respond effectively and with some degree of substance.

Last week Deputy James Browne tabled a Private Members' motion and in all the contributions there was a consensus on what was needed. Initially, people thought an additional €35 million was to be allocated to the mental health budget. It turns out that it is €15 million and will become €35 million in a full year in 2018 and 2019 but the wrong signal was sent by that message. Collectively, we should resolve to find the other €20 million and spend it on the problem. I do not believe the health service can absorb only €15 million extra for mental health. There are issues with the filling of posts but even if that is the case we can resource non-governmental organisations more, such as Pieta House, Aware and others that provide vital counselling services. The primary care counselling service could be expanded and the income threshold could be raised because, at the moment, it is only applicable to medical card holders and not available to children or teens to the degree that it should be. The Jigsaw programme could be expanded and staffing levels in child and adolescent services are 48% below recommended levels.

This is an enormous issue within the community and I question whether we are sending the right signals to the public. With a bit of a will we could do more. We need a national dialogue but, in the interim, we should find the additional resources for the community-based interventions and non-governmental organisations so they have the help and resources to deal with this crisis.

This is a tragic phenomenon that has affected so many areas around the country, not just young people but older people as well. It is hard to disagree with anybody who says we have to do more in terms of a national conversation to deal with the many problems people have. I talked to people involved in third level and many of the services they offer are unable to cope with the fragility of many young people. Our young people display a remarkable confidence yet they are also very fragile and talk about mental health issues in a way that previous generations never did. The appointment of a Minister dealing specifically with mental health opens the opportunity to have these discussions and the budget of the national suicide prevention office has been doubled since 2011. The total allocation for mental health will be €851.3 million in 2017. That will not bring anybody back but it is an increase of €140 million on what was there before.

Deputy Martin is right to speak of his own area, which he knows better than most. I offer my sympathy and condolences to families affected by this spate of suicides. Over the past few weeks, concerns have been raised by HSE staff and communities about the number of deaths in the Togher and Ballyphehane area of the south side of Cork city. A co-ordinated approach, led by the HSE head of mental health services for Cork and Kerry and involving HSE suicide prevention officers, community workers and HSE psychologists and linking with the voluntary sector, has been initiated and a community meeting took place on 14 November. That group is working very closely with the two schools that are affected and close friends, relatives and school and work colleagues of the deceased have been identified and offered support and counselling, while two individuals have been identified as requiring immediate support and their families have been contacted by the child and adolescent mental health services. The HSE suicide prevention officer has made direct contact with the staff in both schools and established links between schools with community-based services such as Pieta House and the National Educational Psychological Service. The schools have offered immediate one-on-one sessions with any vulnerable student and the suicide crisis assessment nurse in the area has been briefed by the local suicide prevention officer, which means that local GPs will also have the relevant information. A new Jigsaw hub is to be opened in Cork and the national task force on youth mental health has been established, one of whose main aims is to increase awareness, not only of mental health but of the assistance that is also available for young people throughout the country. I have some more information about Cork which I can provide in response to the Deputy's supplementary question.

I appreciate that figures vary and we can all provide statistics but only 51% of community mental health staff in the child and adolescent mental health services are in post. There are huge shortages, though I understand that the service cannot fill those posts. However, there is a lot that can be done in 2017 and we should move to identify those priorities. One of those is counselling. There is a lack of counselling and we could move faster on the ex-quota guidance counsellors on which there has been a start this year.

The primary care counselling service is another and a change could be made to give more access to people on low incomes but who might be above the medical card threshold. I use those merely as illustrations. The Taoiseach could support the non-governmental organisations more which also are intervening with young people. We could do that in 2017. Where there is a will there is a way and I believe every Member of the Oireachtas would support that. It would not have to go to a vote or by way of a motion because we can all do that, but action is needed. People, particularly young people who often can be disconnected from politics or the political system, need positive real signals from us that we can make a difference and intervene with effect, purpose and substance. I put that to the Taoiseach and he might reflect on that. I would like to discuss it again with him and follow through with other party leaders to see what in the short term could be done in 2017 to show people that mental health is the priority above and beyond other issues, and that it is not waiting its place in the queue. There is a real fear and anxiety. The Taoiseach mentioned Ballyphehane and other such areas but it is happening across the country. It is a national issue and we must respond to that fear and anxiety as the country's political leaders. I thank the Taoiseach for his response.

It is accepted that there is anxiety and concern about mental health across the country. That has been expressed by the Minister of State, Deputy McEntee, on many occasions, but it is also a fact that for 2017 the amount being allocated to the general mental health area is €140 million more than last year, at €851.3 million. The Deputy is right that this in itself does not deal with the matter but what does deal with it is the extent of assistance and help that is available and it is on that we should concentrate. That is why that community meeting, to which I referred, took place on 14 November. It was agreed at that meeting that safeTALK workshops will take place in the area to explain to young people their value and worth as persons, the assistance that is available for them, that if any person has a little problem or needs to talk to somebody he or she does not need to be afraid to do that and that young people talk about this on a very regular basis. The work department of the HSE and the community are completing the local needs analysis. It is appropriate to say that the task force on mental health set up by the Minister of State is working through the communities to explain to young people that if they have an issue, a concern or an anxiety there is a lot of help available, and that is being channelled through the allocation for 2017. It is a case of having the resources we did not have there before, although perhaps they are not enough but a lot of help is available for a lot of communities. While it will not bring anybody back, it may well prevent somebody from taking that ultimate tragic step.

I am very disappointed with the Taoiseach's answer. There is not a lot of help available. This morning we have an article the Irish Examiner on 16 suicides that have happened in Cork in the past fortnight. Today it is Cork; another day it will be Kerry or Louth or Belfast. All sections and generations are affected by this issue from the very young to the very old in urban and in rural areas. I know the Taoiseach has had personal experience of this. It is at a human cost beyond comprehension. One in seven adults experiences mental health challenges in any given year. In 2015, there were 451 recorded suicides in this State and there were 318 in the North. We all know that under-reporting is widespread, so the real figure across the island may be as high as 1,000. It is also recorded that at least 8,790 citizens presented with self-harm at hospitals in this State.

I will cite a local example. The Ladywell mental health service in Dundalk provides services for most of north Louth. Its staff are extremely dedicated but the rooms they operate from were originally hospital staff quarters and date back to when the Louth Hospital was built 70 years ago. Some of the rooms are closed because of dampness. The maintenance bill alone is a huge drain on the service's resources. Staff numbers have increased but there is no room for them at the Ladywell facility so they are based in Ardee. This means that people in Carlingford who need to access the service have to travel to Ardee, which is entirely unacceptable. That is an example of the service available in that area.

The State's mental health policy, A Vision for Change, is ten years old and ten years on there is still an absence of 27-7 crisis care. Staffing levels are 75% of the recommended number in A Vision for Change and in some cases they are well behind that figure. Staffing in child and adolescent teams is half that which is recommended. A Vision for Change commits the Government to providing 8.24% of the health budget to mental health services. That target has never been met and that pattern is repeated in this year's budget. An allocation of €35 million was announced but the Minister then said that only €15 million in additional funds would be provided for next year. That is an increase of less than 2%. I am sure the Minister of State, Deputy Helen McEntee, is doing her best and we wish her well. All parties and all Independents should work with her but the Taoiseach needs to give her the required resources.

The fact is that this Government has failed like the previous Government to implement the A Vision for Change strategy. Will the Government commit to publishing a time-lined implementation plan - it does not need to do it today but it could do it next week - for the outstanding elements of A Vision for Change?

I do not object to that. A Vision for Change was published with the intent of implementing it in full. That is a challenge but I do not disagree with it. It was not published for the sake of just having another publication.

The Headstrong organisation developed the Jigsaw model and it is now delivered throughout quite a number of counties and districts, including Donegal, Galway, Roscommon, Kerry, Meath, north Fingal, Dublin 15, Tallaght and Clondalkin and it is to be extended to other areas. The Jigsaw unit in Cork will be operational in 2017 and the HSE provides over €9 million there. I have experience of some of these having visited them. They are organised, run and structured by young people and it is amazing the way they connect with each other as young people to help those who have particular challenges or little concerns.

The national task force on mental health, which people had sought for a long time, was set up by the Minister of State in the first 100 days of Government and it deals not only with young people but also with older people. It is made up of a diverse group of 18 leading national figures who are very competent to speak on these matters. They represent a number of different sectors, including the public, private, community and voluntary sectors, and look at the areas of improving emotional literacy in the population; awareness of the services and the supports that are available; accessibility to those services and the supports at different times and in different areas; and the alignment of the services and the supports, which is important, across different providers in terms of public, private, community and voluntary organisations. That task force has held three very productive meetings. It agreed key factors for its work. It has visited front-line services, including a number of the units around the country, where it met the service users, parents and front-line staff. One of the elements of the Minister of State, Deputy McEntee's, commitment is to ensure the voices of young people and children are at the centre of that task force's work. The first in a series of consultations was held with young people aged between 19 and 25 on 17 November. The young people discussed what help and assistance would be useful, what hurts their mental health, what impacts on them, the changes they would like to see the task force deliver, and a report on this will be brought to the task force's December meeting. Each task force member has identified a number of individuals or organisations in their sector that have a depth of expertise and experience of youth mental health issues, services and solutions to form a small community of practice that will be available to those who need it and that will also offer views, ideas and perspectives from their sector to the task force being charged by the Minister of State, Deputy McEntee. That helps to ensure that the work of the task force is informed in the best way possible because it is coming from young people.

I also add that the Government has made money available to the Minister of State, Deputy McEntee, for a major development at Portrane at a cost of €40 million plus, which has been awaited for nearly 100 years.

I do not dispute what the Taoiseach said. Jigsaw, which is a great programme; the personal independence payment, PIP; Save Our Sons and Daughters, SOSAD; and Circle of Hope are all great initiatives. Advocates such as Conor Cusack, the Rubberbandits and Bressie have engaged in a lot of consciousness-raising, particularly of stigma. However, it is not enough because they cannot do it alone. A vital part of dealing with the risk of suicide is having adequate services in place throughout the day, seven days a week. A 24/7 intervention service is possible, but the Government needs to make it a priority. If it does not do so, it will not happen. I have been working on this issue for about 25 years, North and South. Many of those who will take their own lives will never be in touch with the mental health service. Given the absence of services, that is hardly surprising. There is almost - I use the term advisedly - a copycat element to suicides in some parishes and communities. My point to the Taoiseach and everybody else is that we must recognise this as a national emergency and put in place measures to tackle it. We need action and an emergency task force to be set up across the State which would work in co-operation with colleagues in the North and local communities. I, therefore, ask the Taoiseach to commit to dealing with this as an emergency and act on it as he would in any other emergency.

I accept the Deputy's earlier remark about A Vision for Change and the setting out of a timeline and a strategy to implement the programme, although that will take some time. However, within our first 100 days in government, the national task force on youth mental health was established. It comprises 18 leading national figures. Its intent is to draw on the concerns and anxieties and the conversation of young people to address what they believe impacts on their mental health and the extent to which they have access to the supports and assistance available. People should understand that if they know somebody with mental health difficulties through their digital connections - Facebook or the other ways in which young people connect with each other - help and assistance are available in a way that they were never available before. The structure being put in place by the Minister of State, Deputy Helen McEntee, will be built on in the time ahead. More than €800 million has been allocated for general mental health services in 2017, up €120 million on the previous allocation. While it is never enough, this shows that mental health service provision is a priority for the Government. I accept the remarks made by Deputies Micheál Martin and Gerry Adams. Nobody in this House, of any party and none, disagrees with the concept of a national response to what, sadly, is a tragic phenomenon. The Minister of State, Deputy Helen McEntee, is working exceptionally hard to spread the message throughout the congregations of young people, and older people, that if they have mental health difficulties and are challenged in whatever way, there is a lot of assistance and support available. I hope this will prevent, in whatever numbers, those who might be inclined to take the ultimate tragic step from doing so.

Seanad Éireann recently passed my party's Competition (Amendment) Bill, which has now been placed on the Order Paper of Dáil Éireann. As I think it is the first Private Members' Bill that will pass all Stages in either House since the general election, I am naturally pleased that the Government has accepted the legislation and tabled useful amendments to improve it. The Bill only deals with the one aspect of bogus self-employment. There are pernicious and unacceptable arrangements simply to save bogus employers the cost of social insurance. Employees are coerced into falsely describing themselves as self-employed or independent contractors and, in so doing, are required to exclude themselves from the protection of employment law and the welfare system. The European Court has ruled that one is falsely self-employed if one does the same work as an employee, if one is in a relationship of subordination and required to follow instructions about the time, place and content of one's work and if one is integrated into the employer's undertaking. The Bill the Labour Party presented to the Seanad directs regulators to see through this sham and address the reality rather than the pretence. In truth, the people affected are employees and must be treated as such, with access to the rights granted in and the procedures of the employment system. The Bill is a first step and deals with just the one aspect: the right to join a trade union and bargain collectively. Does acceptance of the Bill in the other House signal a new approach to the issue, namely, a determination to tackle bogus self-employment? With a statutory definition now available, as agreed by the other House, will the Government ask the tax and welfare authorities to fully engage on the issue? Each has its own investigative unit. Will the Taoiseach ask the Revenue Commissioners and the Department of Social Protection to address and identify the issue of bogus self-employment? Is the Government determined to use all of its powers to stamp out a practice that is destructive of employees' security and rights and bring employers and employees back into the correct and proper environment regulated by law?

That is the environment in which everybody wants them to be. I am glad that the Bill brought forward by the Deputy's party in the Seanad was accepted, with amendments. I assume that the Deputy will bring the Bill before this House in Private Members' time. If it has been accepted by the Government in the Seanad, I do not see what objections will arise in the meantime. We will need to study the implications of the Bill fully, but its intent is correct. It is right that there be proper legal coverage for employees and no bogus employers. I understand the Revenue Commissioners and the Department of Social Protection are engaged on the issue and that a joint working group has been set up. Enforcement is being stepped up, especially in the construction sector in which elements of bogus self-employment were clearly evident. I suggest the Deputy bring the Bill before this House. In the meantime, the working group set up by the Revenue Commissioners and the Department of Social Protection will continue to focus on the issues in hand.

I thank the Taoiseach for his response. Bogus self-employment costs the Exchequer millions of euro in lost tax and social security contributions, but, more importantly, it deprives workers of a vital social safety net. As the Taoiseach referenced, a consultative process on bogus self-employment was initiated by my colleague, Deputy Joan Burton, when she was Minister for Social Protection, and ran up to 31 March this year. What was the outcome of that consultation? Will the working group publish a report and, if so, when? Will it publish recommendations and, if so, when will we see them? Private Members' time is very scarce for all of us on the Opposition benches. May we have agreement to take a Bill such as this outside the time allocated for both Government and Opposition business if it is an issue of such importance?

In the spirit of new politics, that matter may be discussed by the Business Committee. The Minister for Enterprise, Trade and Employment, Deputy Mary Mitchell O'Connor, welcomed the cross-party agreement in the Seanad on 10 November. The Competition (Amendment) Bill was introduced, as Deputy Brendan Howlin knows, by Senators Ivana Bacik and Gerald Nash. When enacted, three categories of workers, namely, voice-over actors, session musicians and freelance journalists, will be exempt from section 4 of the Competition Act 2002 and allowed to engage in collective bargaining.

Additionally, a formal response is set out allowing trade unions to apply for similar exemptions for certain categories of self-employed workers. The Minister was happy to work with Senators Ivana Bacik and Gerald Nash in that regard and they were complimented on the collaborative way in which they had worked with the Government. As the working group established by the Revenue Commissioners and the Department of Social Protection decides on the issues to be dealt with, the Minister will make a response when it has finalised its work. I am sure enforcement is being stepped up.

Does the Taoiseach know when the Minister will respond?

The amendments insert a new Part 2B into the Competition Act 2002 and provide for the application of section 4 of the Act to collective bargaining and agreements for certain categories of worker. Also a new Schedule 4 is to be inserted into the Competition Act to give effect to a previous Government commitment, given in the programme of Government, Towards 2016, on review and transitional arrangements. The exemptions will take effect when the Bill comes into force and an application for an exemption will not be required for the three categories listed in the Schedule. The amendments allow the Minister for Jobs, Enterprise and Innovation to bring the legislation into operation by order, with different days being appointed for different purposes, as the Deputy is well aware. It also provides that the entire legislation shall come into operation no later than three months after its enactment. If the Business Committee decides to take the Bill early, I do not see why it cannot have the support of the House and be passed into law.

I concur with the comments of previous speakers on the epidemic of suicide, but I would like to refer to another epidemic in our society, that of gender-based violence. This Friday women around the world are, for the first time, being asked to go on strike or wear black as part of an international day of action against violence perpetrated against women. One in three women in the world will in her lifetime have experienced being beaten, coerced into sex or otherwise abused. Safe Ireland estimates that one in four Irish women has experienced physical and sexual violence by a male partner or non-partner since the age of 15 years. One in three has experienced psychological violence, which can also be extremely difficult. At what is meant to be a special time in a woman's life, the Rotunda Hospital estimates that one in eight pregnant women experiences violence. If 25% of all violent crimes involved a man assaulting his wife or a partner or if this was gangland crime, it would be shouted from the rooftops and there would be screaming headlines, but this issue is barely spoken about in schools or workplaces. How much of a priority is it for the Government? How much does it care about the issue of domestic violence and violence against women? Based on the evidence, it does not rate very highly.

The question is often asked, "Why does she stay?" What can a woman expect if she tries to escape a violent relationship in Enda Kenny's Ireland? First, she may not be lucky enough to even get through on the telephone to one of the helplines because the Government has systematically cut funding for organisations such as Women's Aid. If she seeks refuge, she will probably become one of 6,000, the number of women who were turned away from refuges last year, amounting to 16 every day. Does the Taoiseach know what happens to them? That is a jump of 1,000 on the figure for the previous year, but the Minister responsible for housing is only promising to provide eight refuge spaces next year. If a woman needs to move on from a refuge, there is no housing available because of the housing crisis that has been allowed to fester. The domestic violence charity Sonas told the Oireachtas Joint Committee on Housing and Homelessness that many women were staying in the home to be abused rather than risk homelessness. If a woman tries to obtain a safety order, she will hit a wall as the waiting time for a hearing at Dolphin House is 20 weeks and there are no emergency barring orders granted when a court is not in session. The Government has increased free legal aid fees from €50 to €130 since 2013 alone.

In a "Prime Time" special last night we saw the level of violence against women. Male violence is a product of centuries of patriarchal culture and I am not asking the Taoiseach to solve it in one day. Will he specifically agree to increase the number of refuge spaces to the European norm of one per 10,000 people? Will he agree to provide rent allowance for any woman fleeing domestic violence? Will he stop the cuts for the rape crisis centres, Women's Aid and other services and instead invest properly in them? Will he also agree to the legislative changes we need? Will he drop the fees for any woman who is seeking a protection order?

I agree with many of the sentiments expressed by the Deputy on the matter. Those who beat women shame manhood. It is a crime to beat a woman and those who profess, in their manhood and machismo, that they are doing good by beating women do down themselves, their families and the nation. I am appalled by it. The two words "domestic" and "violence" should never go together. Only last week the Tánaiste and Minister for Justice and Equality launched the "What Would You Do?" campaign on domestic violence, which is part of the second national strategy on domestic, sexual and gender-based violence campaign, 2016 to 2021. It is about prevention, empowerment and support. It offers hope and help to victims of violence and empowers us as witnesses of such violence to find out what we can do to help stop domestic violence and support those caught up in it.

I recently had the privilege to present certificate awards to members of the Traveller community and had a long conversation with some of the women present. They had never spoken about domestic violence, although many of them experienced it. We are now trying in that category to train a number of counsellors to draw out these women to speak about their experiences and do something about it. We signed the Istanbul Convention on 5 November 2015 and the Government is following a multi-annual action plan to deal with the remaining legislative and administrative issues raised by the Deputy. When implemented, the measures will allow us to ratify the convention. The domestic violence Bill will represent a major step forward on Ireland's path towards ratification. It is at an advanced stage of drafting. It is intended that it will be submitted for Government approval and publication before the end of the year.

Provisions on domestic violence will be brought together in one piece of legislation to make it easier to use. Other improvements made in the Bill include an extension of access to an interim barring order for eight working days in an emergency or crisis and a provision that a person will no longer have to have a greater or equal property interest in the property from which a perpetrator is barred. A victim will be able to bring a friend, family member or support worker into court during proceedings. Additionally, it will be possible for a victim to give evidence by video link to avoid the risk of intimidation or being beaten up by a perpetrator or an associate. The anonymity of a victim, dependants and the perpetrator will be protected in criminal proceedings for breaches of orders, other than where the victim chooses not to be anonymous. This is intended to protect the privacy of a victim. the media will be able to report on proceedings, provided they respect the obligations concerning anonymity. It will also be possible to bar a perpetrator from communicating electronically with a victim.

This is a priority matter for the Minister and the Government and we will follow through on these and other issues.

They were fine words, but at the same time the Taoiseach has cut funding for Women's Aid by 20%. Women are now in more danger since he came to power than they were before because of the housing crisis, in particular.

There are more women who cannot get into refuges and have nowhere to go. Following the recent horrific murder-suicide of an entire family, a woman's memory was completely obliterated by the media. That is the position on male violence against women. One of the features of the "Prime Time" programme was that young women were in severe danger in relationships also. Approximately 60% of abuse starts before the age of 25 years. We are in the ha'penny place when it comes to things like stalking legislation. New revenge porn weapons and tools are being used by men to control or abuse women. The macho culture that objectifies and abuses women is continuing unabated. This Friday women will gather on the Rosie Hackett Bridge in Dublin at 1 p.m. and St. Patrick's Bridge in Cork at 5 p.m. to protest against violence against women and the ongoing eighth amendment. Women in 30 countries will take part in similar protests. Women are becoming politicised and radicalised and will not put up with this like they might have had to do in the past.

I will support women very strongly on this issue and in their action on Saturday. Deputy Kate O'Connell has circulated the details to every Member of the House.

The action is against the Taoiseach.

In 2016 Tusla is providing €20.6 million to fund the provision of supports for those affected by domestic, sexual and gender-based violence. Sixty services throughout the country are being supported from this fund. Some €12 million is being provided for emergency refuge and support services, almost €5 million is being provided for community-based domestic violence support services, while €4 million is being provided for rape crisis centres. Tusla is being granted an increase of €37 million in 2017. It will result in increased expenditure on the work it does in various areas throughout the country such as the provision of funding for 147 family units of emergency refuge space and eight family units of emergency non-refuge space. In the course of this year eight additional family units of accommodation, six additional units of emergency refuge accommodation in Dublin and Kildare and two emergency safe housing units in Sligo were funded by Tusla. As I mentioned, funding of €950,000 has been provided in 2016-17 for the "What Would You Do?" campaign, which was launched by the Tánaiste. I hope this will make a real impact on awareness of the shameful conduct of domestic violence.