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Joint Committee on Education, Further and Higher Education, Research, Innovation and Science debate -
Tuesday, 25 Oct 2022

Mental Health Supports in Schools and Tertiary Education: Discussion (Resumed)

I welcome everyone to our first session today. On behalf of the committee, I welcome Ms Máirín Ní Chéileachair, director of education, research and learning at the Irish National Teachers Organisation, INTO, Ms Sarah Behan, vice president for welfare at the Union of Students in Ireland, USI, Mr. Frank Jones, general secretary of the Irish Federation of University Teachers, IFUT, Mr. David Duffy, education and research officer with the Teachers Union of Ireland, TUI, Ms Angelica Foley, welfare officer at the Irish Secondary Schools Union, ISSU, Mr. Gary Honer, industrial relations officer with Fórsa, and Ms Moira Leyden, assistant general secretary of the Association of Secondary School Teachers in Ireland, ASTI. The trade union officials are with us to discuss mental health supports in schools and tertiary education. I will invite our guests to make a brief opening statements in the following order: Ms Ní Chéileachair, Ms Behan, Mr. Jones, Mr. Duffy, Ms Foley, Mr. Honer and Ms Leyden. I also welcome Ms Noreen O'Mahoney, chair of the Fórsa education division, Ms Joan McCrohan, Fórsa organiser, Ms Liz Farrell, president of the TUI, Ms Sarah Hughes, USI mental health project manager, Ms Martina Genockey, public relations and communications manager with USI and Mr. Conor McDonald, executive officer with ASTI, who are in the public gallery. The opening statements will be followed by questions from the members of the committee. Each member has a total of five minutes to pose questions and get responses from the witnesses. The committee will publish the opening statements on its web page following today's meeting.

Before we begin, I remind members of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the House or an official, either by name or in such a way as to make him or her identifiable. The union officials are reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity, by name or in such a way as to make him, her or it identifiable or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity. If their statements are potentially defamatory in relation to an identifiable person or entity, they will be directed to discontinue their remarks and it is imperative that they comply with any such direction.

I invite Ms Ní Chéileachair to begin and ask all of our guests to be brief as possible with their opening statements so that committee members will have as much time as possible to interact with them.

Ms Máirín Ní Chéileachair

Tá Cumann Múinteoirí Éireann thar a bheith buíoch as ucht an deis labhairt os comhair an chomhchoiste.

We ask the committee to note that over the years the INTO has highlighted the topic of mental health. At its annual congress in 2022 a comprehensive motion was passed on the mental health of primary school children. Our education consultative conference in 2021 had a focus on well-being and mental health. Mental health was included as a topic at our equality conference in 2013.

We want the committee to note that the culture in which Irish primary schools operate is one that strives to be safe, healthy and inclusive for all pupils regardless of social background, race, self-identity and learning needs. Primary teachers are profoundly aware of the importance of the well-being of their pupils. The challenge of protecting the mental health and well-being of primary school children must not be underestimated.

National research carried out with children and young people by the Royal College of Surgeons in Ireland in 2013 suggests that approximately one in three young people will have experienced some type of mental disorder by the age of 13. This rate rises to more than one in two by the age of 24 years when intervention does not take place. This is more than 50%. Research conducted by Dublin City University in 2017 found that the psychological well-being needs of children in primary school are complex. This research identified a range and severity of difficulties that children present with in primary schools. It also focused on the varied family and cultural contexts that are a feature of their daily lives. Critical incidents of a serious nature that schools deal with include separation, divorce, marital breakdown, anxiety, bullying, cyberbullying, self-harm, suicidal ideation, eating disorders and sexual identity issues. All of these impact on the mental health of children.

Ireland's child and adolescent mental health services are experiencing significant difficulties. These have been well publicised and include a lack of services at community and school level, difficulties in recruiting qualified staff and excessive waiting lists for specialist mental health treatment services. School principals have reported wait times of up to four years in some cases. This is unacceptable and cannot continue.

The service that engages with children on an almost daily basis is the school. Schools and school personnel must be supported by all other services when nurturing the positive mental health of pupils. It is acknowledged that our mental health is influenced by our daily lives and that the foundation of good mental health starts in our youth. In other jurisdictions, schools are recognised as the optimal venue for youth mental health promotion and prevention programmes as they are the only venue where all children and adolescents in society can be reached. In those jurisdictions mental health professionals work in schools, alongside teachers, to support the mental health of pupils.

The Covid-19 pandemic has exacerbated stress and anxiety among children. During school closures some pupils regressed not only in their learning but also in their social and emotional well-being. Guidance published by the Department of Education in September 2020 advised that well-being be prioritised in our schools. Teachers recognise the impact the trauma of the pandemic has had and seek increased resources for primary school teachers to adequately support children's mental health in the months and years ahead.

At its congress in April 2022 the INTO noted the dearth of mental health support services for primary school children. During the debate on children’s mental health delegates reported that more and more children present in primary school classrooms experiencing anxiety, poor mental health and poor emotional well-being. The congress called for increased National Educational Psychological Service, NEPS, provision for schools and clarity regarding the level of provision that schools can expect, a national framework to inform the development of counselling services for primary school children and resources to introduce on-site school counselling in primary schools in line with international best practice. We are delighted to welcome the Minister's recent announcement of €5 million to fund a pilot programme of counselling supports in primary schools. We look forward to her engagement with stakeholders on the matter.

We note that Government policy dictates that all mental health and other professional services are provided in the community. There is extensive international research to indicate that services co-located in schools experience a higher level of engagement and success. We would argue that schools are an integral part of the community of children and families and ask the Government to re-examine and redefine "community" in this context.

The INTO recommends that schools are provided with adequate, age-appropriate supports for children presenting with mental health difficulties, increased NEPS provision for schools, the development of a national framework to inform the development of counselling services for primary school children and funding and resources for this. It also recommends increased funding for child and adolescent mental health services and sufficient up-to-date professional development supports for teachers. The INTO recognises the urgency in providing mental health supports for primary school pupils, especially at school level.

They must be properly resourced and meet the needs of the school community. We remain committed to the support of the pupils in our care.

Ba mhaith liom mo bhuíochas a ghabháil leis an gcomhchoiste as ucht éisteacht liom inniú.

Ms Sarah Hughes

To clarify, Ms Sarah Behan is unwell today. I am Sarah Hughes, the mental health programme manager.

I thank the Chairperson and members of the Oireachtas committee for the opportunity to speak to the committee today. I am the mental health programme manager for the Union of Students in Ireland, which is the national student representative body for students in third level education.

I want to draw the committee's attention to the current issues we are facing with regard to mental health funding in higher education institutions, HEIs.

The current funding allocated to mental heath support in HEIs is not core or multi-annual. While the extra funding provided for mental health during Covid is greatly welcomed, it only brought the student-to-counsellor ratio to 1:2,500, rather than the best standard practice of 1:1,000. This funding also only refers to core counselling clinics and does not take other staff, such as GPs, health nurses, disability support staff or administrative staff, into account, although they may be needed to fully support student mental health. A whole-of-campus approach is recommended by the national framework, and this cannot be achieved without core multi-annual funding.

While international researchers are loath to speak to an increase in mental health problems and suicide levels post-Covid-19, data from within Ireland, such as from the My World Survey 2 study, indicate that within this cohort mental distress was increasing prior to the pandemic, and appears to have continued to increase throughout.

Without core multi-annual funding, additional staff can only be hired on short-term contracts. This not only makes it difficult to hire appropriately-skilled staff, but also makes any kind of planning beyond the short term almost impossible. In addition, there is currently no information on how the mental health funding from the recent budget will be allocated. This is resulting in campuses not knowing whether they can keep staff on, or if they need to cut services. Ring-fenced multi-annual funding is needed to ensure that the mental health of students is seen as an integral aspect of college life.

Mental health staff are struggling to deal with the current demand of students presenting themselves in distress. Recently, on a campus visit, I saw the strain that is being put on services, as there was only standing room left in the waiting room for an emergency counselling drop-in clinic. It is important to note the fact that counsellors are expected to take on additional work related to the roll-out of various welfare-related policies. We have recently seen funding being allocated to allow for appointed roles to help with the roll-out of frameworks relating to ending sexual violence and harassment. We need to see similar funding being allocated to help with the roll-out of welfare-related frameworks. Without it, it may come down to a counsellor having to choose between rolling out a framework or dealing with students in counselling sessions.

Increased multi-annual targeted funding for student counselling services and other student support services must be put in place to allow for the continued roll-out of services to meet demand on an ongoing basis, and in line with recent publications such as the National Student Mental Health and Suicide Prevention Framework, Healthy Campus and 3Set reports.

We are seeing an increase in students who are registered as having a mental illness in higher education institutes. That does not include students with sub-clinical needs but who may need mental health supports throughout the year. We all have mental health and should be able to access supports easily when they are needed. While the launch of initiatives such as Togetherall is helpful, it should be in addition to core funding. After all, the aim of Togetherall is to meet a sub-clinical need.

A requirement of students applying to college through the disability access route to education, DARE, scheme is the provision of diagnosis by a consultant psychiatrist only. Ireland does not maintain an adult mental health service waiting list. However, it is widely accepted that were such a list to exist, it would be long and growing. This would be something similar to the child and adolescent mental health service, CAMHS, waiting list, which is exceptionally long. Many young people who are already engaged with psychology services are forced to join the end of psychiatry waiting lists because their current treatment provider is not permitted to verify their diagnosis.

Allowing psychologists to certify diagnoses for the purposes of DARE would not only reduce psychiatry waiting lists, but would also allow the higher education sector to take a step closer to being more inclusive, and is something that Union of Students in Ireland, USI, would fully endorse. USI supports the Psychological Society of Ireland, PSI's call for equity of funding for all trainee psychologists, including educational psychologists, and for an increase in places available on trainee courses to increase the number of mental health professionals in Ireland to a level that can meet demand, both on campus and across the country more broadly. USI calls for a change to DARE and in-college accommodations through disability services to move from only accepting a diagnosis from psychiatry to allowing a diagnosis from a PSI-accredited psychologist.

Best practice recommends increasing peer support to increase both mental health supports on campus, and to support student engagement, thus reducing drop-out levels. Work has also begun, both nationally and internationally, in examining the prospect of embedding well-being into the third level curriculum.

However, the issue to date here is that the majority of this work has been at local level in an ad hoc way, not always centring the student voice in the development of such programmes. The Union of Students in Ireland recognises the continued work to increase student participation and the student voice in student mental health work across the sector is vital and must be done in a non-tokenistic co-creation approach.

National co-ordination, collaboration and funding is needed to help these programmes to grow in a way that works for each campus. The recommendations in the 3Set report, including, but not limited to, the National Student Mental Health and Suicide Prevention Framework, should be fully implemented and sufficient funding allocation to allow for this must be provided.

Mr. Frank Jones

The Irish Federation of University Teachers, IFUT, is the only union in Ireland that exclusively represents workers in higher education. We represent many grades of workers, including lecturers, researchers, tutors, teaching fellows, librarians and administrators. IFUT understands quite rightly that much of the focus of this round-table discussion on mental health supports in schools and tertiary education will be framed in the context of student needs. Therefore, we will focus on issues for employees in this sector that adversely impact on their mental health.

In recent months, IFUT welcomed the opportunity to appear before the Joint Committee on Education, Further and Higher Education, Research, Innovation and Science in relation to the funding requirements of higher education. The committee published the report, The Future Funding of Higher Education, in July 2022.

In relation to today's topic, that report contains many contributions from parties who operate in this sector which are as relevant now as then. In particular, Chapter 8 "Mental Health and Well-being Supports” considered the current demands for mental health support in higher education. There is a recommendation 9 there that I am sure members of the committee are interested in.

IFUT is of the opinion that recommendation 9 adequately and succinctly addresses the core issues in the university sector which negatively impact staff, students and the quality of education and, indeed, the causes of mental health issues, namely precarious employment, the continued application of the employment control framework and the failure of staffing levels to keep pace with the expansion of student and programme numbers thereby resulting in the Irish staff-to-student ratio being one of the largest in Europe. Precarious employment and a high staff-student ratio create an unmanageable workload culture on the mental health of the people working in the sector.

A 2017 study into work-related stress within the higher education institutions, HEI, sector, the Foy report, found that unrealistic demands, lack of resources and constraints on employees lead to stressful workplaces and ultimately lead to a deterioration in mental health. The report concluded that tackling the causes of work-related stress also makes business sense as doing so leads to reduced absenteeism, higher productivity and lower employee turnover. A 2015 study which examined precarity and casualisation in the Irish education sector noted that "Many casual workers encapsulated how they felt about their situation with negative descriptors like 'depressed', 'frustrated', 'worried'’, 'despondent and hopeless', 'disillusioned', 'demoralised ...".

In an article in The Irish Times on 12 October this year about university rankings, TCD Provost Professor Doyle states:

The poor staff-student ratio is directly related to the underfunding of the higher education sector in Ireland. It is vital that Government honours the commitment made earlier this year in 'Funding the Future' [report] and increase annual core funding by €307 million for the higher education sector in Ireland.

While university rankings are something that may appear to be arbitrary at times, the issue of student-staff ratios are a very serious matter. IFUT has concluded that there is no systematic effort being made in Ireland to act on the recommendations contained within this report.

In the workplace IFUT is responding regularly to new precarious posts and roles being created for members on fixed-term contracts for years, and even decades. Members' contracts run for nine months of the year but they are expected to mark examinations, engage with students and prepare for the next semester during their three months without pay. Many of these workers are completely invisible. They are not on staff lists, email lists or invited to staff meetings. No one truly knows the extent of the problem of precarious employment in this sector in Ireland. Figures which are gathered on headcount tend to count full-time equivalents, FTEs. In the case of part-time or hourly workers, one full-time equivalent could include ten or more real suffering workers.

The committee recommended that the staffing levels of universities "be reviewed urgently or by end of 2022 at the latest". We are fast approaching the end of 2022, but we in IFUT are not aware of any process involving any trade union for examining this issue.

IFUT members report a significant difficulty in making time to provide the pastoral care to students that they deserve and require. Students may not realise that the lecturer standing before them is on a contract for three hours per week. When a student requests a one-to-one discussion on the course content or difficulties he or she is experiencing, the student should expect support to be forthcoming. Little do students know that their lecturers might have to run off after a class to work a second or third job to make ends meet. This disastrous employment culture is bad for the employee, but also for the students they teach. The unavailability of lecturers to students will contribute to stress and anxiety for the students.

With daily demands on their time, the ability of some employees to conduct research is curtailed. This will have longer-term devastating consequences for the quality of the research and education that the institutions provide. Burnout is real among academics in higher education.

We all know that trade union-organised workplaces are safer workplaces. In higher education, though, there is a limit to what trade unions can do to impact the work environment without national policy supporting the workers in these institutions. Conversations about mental health in higher education need to look not just at the supports for workers when they experience mental health problems, but at the causes of workers' suffering in the first place. IFUT wants to be centrally involved in agreeing decent work, fair workloads and adequate staffing levels across universities and other higher education institutions. We want to be part of shaping the solution with this committee.

Mr. David Duffy

The Teachers' Union of Ireland, TUI, thanks the committee for the opportunity to make this opening statement on the topic of mental health supports in schools and tertiary education.

The prevalence of mental health difficulties is a significant issue, not just for the education system, but for society as a whole. The two education Departments and the wider State have a duty of care not just to students, but also to staff, to support their mental health and well-being. Education settings, whether post-primary, further education or higher education, can play a vital role in supporting students, staff and families in terms of mental health. However, education settings cannot do this on their own. They need support from those same families, the wider community and taxpayers if mental health is to be addressed satisfactorily. It is also essential that support services, both inside and outside the education system, be resourced to provide specialist assistance as required.

Mental health difficulties existed long before the Covid-19 pandemic, but the pandemic has made matters worse. The TUI is committed to supporting meaningful measures that support students who experience mental health difficulties and their teachers or lecturers who educate them but who can also experience mental health difficulties of their own.

Schools and colleges require support from relevant agencies with expertise in mental health if they are to support the affected students adequately and appropriately. Cuts to pastoral care supports in schools, such as in guidance provision and middle management posts, have also made it difficult for schools to support students in these demanding situations. The loss of pastoral supports such as assistant principal positions is a situation that the Department of Education has described as "unsustainable". These posts of responsibility are essential in building relationships and identifying issues, especially as a mainstream post-primary teacher usually sees approximately 250 students every week.

Mental health support services in tertiary education are significantly understaffed in terms of counsellors, pastoral staff and those with special responsibility for supporting students. This is even before we take into account the expected increases in student enrolment in further and higher education. Additional staffing is vital. Mental health can also become an issue for staff themselves. Staff may encounter such difficulties in either their personal or professional lives and it is essential that adequate support be available to them too.

The TUI would like to make a number of recommendations to the committee. Mental health in education settings should be taken seriously and appropriate investment of resources, provision of time and training should be made in it for both students and staff. It is essential that vital support services within schools be restored.

This includes, but is not limited to, guidance support and middle management posts. Significant investment is needed in out-of-school and out-of-college supports such as child and adult mental health services. An inclusive support structure should be set up in schools and colleges with access to all the necessary professionals and referrals in a timely manner. Staffing in NEPS should be expanded to allow for greater one-to-one direct support for students from NEPS psychologists. We note that some additional staffing has been provided. A trickle-down model on its own simply is not enough. The number of counsellors and psychologists in tertiary education support services should, as my colleague from USI said, be increased to the international recommendation of one per 1,000 students. Training should be provided to teachers and lecturers in how best to refer on students and how to interface with the appropriate services. The HSE should allow students to access community mental health services in their local community during holiday periods and to access education settings for mental health support during term time and vice versa. Significant additional staffing should be provided to the adult education guidance service. Learners in further education and training, FET, such as Youthreach should have access to a broad range of guidance and counselling supports, as required. All education staff should have access to mental health support programmes for themselves and for the support of their students. There should be access to dedicated support teams who work directly with staff and students focusing on prevention over cure. I thank the committee for listening to this opening statement. The TUI would be happy to answer any questions members may have. The TUI would also like to direct the committee to the more extensive written submission we made in August, which provides more detail on the issues I have outlined.

Ms Anjelica Foley

Gabhaim buíochas leis an gCathaoirleach, na Teachtaí Dála agus na Seanadóirí. Táim thar a bheith sásta a bheith anseo inniu chun meabhairshláinte a phlé. Anjelica Foley is ainm dom agus is mise an t-oifigeach leasa d’Aontas Daltaí Iar-bhunscoile na hÉireann. The Irish Second-LeveI Students’ Union, ISSU, is the national representative body for second-level students in Ireland. Our core aims are to provide a collective voice for second-level students and to fight for a fair education system that values each individual and allows them to reach their full potential. Access to adequate and integrated mental health supports in schools and throughout the education system are crucial to allowing students to achieve their full potential. The ISSU is fully committed to working alongside stakeholders to find solutions to the issues students face. It is in this spirit that I am before the committee today.

As we are all keenly aware, the Covid-19 pandemic has had a catastrophic impact on students’ mental health. While schools are no longer closed and mask-wearing is no longer enforced, the repercussions and aftershocks of the Covid-19 pandemic are still being felt by many students around Ireland. This is not the only challenge students face. There are countless other factors that affect their mental health and students' mental health is undoubtedly suffering in an increasingly online world. If we are to provide adequate mental health supports for students we must also investigate the causes of mental health difficulties among students. Students' lives can be stressful enough outside of school, but the fact of the matter is that our education system is actively damaging students’ mental health. The reformed junior cycle has developed a more holistic approach to education. The recently released draft social, personal and health education, SPHE, short course curriculum is evidence of this. Recently, Department of Education inspectors found that only one in five schools timetable SPHE at senior cycle. As per our submission, the ISSU recommends the creation and integration of modules within the SPHE curriculum in both junior and senior cycle to educate students about dealing with both their own mental health and how to support their peers.

Year after year, the leaving certificate and the CAO cause immense anxiety and stress among students. In 2016, the United Nations Committee on the Rights of the Child made "a very strong recommendation" for reform of the leaving certificate, citing the severe stress it places on students’ mental health. The role of guidance counsellors in helping students has not gone unnoticed; as outlined in our submission, we recommend the introduction of a direct referral route for guidance counsellors when a student avails of one-on-one counselling and the provision of funds to schools to introduce an on-site psychologist.

A persistent stigma surrounds mental health in Ireland, particularly among boys and young men. It is crucial, therefore, that student engagement and peer support be improved to further support the mental health needs of young people. Initiatives such as Jigsaw's One Good School programme engage students as partners in the creation of a better environment for mental health in their school communities. Further development of such programmes must happen in collaboration with students to ensure the student voice is represented.

Furthermore, it is important to acknowledge schools and places of education are often the first port of call when addressing any mental health difficulties a students may have. To this end, it is vital we invest in early invention and at the same time introduce mandatory mental health training for teachers and all school staff during their initial training. This is important in ensuring we have a proactive whole-school approach to mental health.

Unfortunately, as with many other educational issues, mental health does not affect all students equally. Students from the Travelling community, students of colour and those from other minority groups, including the LGBTQIA+ community, are at a much higher risk of developing severe mental health difficulties. Alongside further mental health training, we must introduce mandatory anti-discrimination training to tackle the increased prevalence of mental health difficulties among students from minority groups.

Currently, mental health supports in schools are far from perfect. Some students will require mental health supports outside their schools. Increased investment in pre-existing services to expand capacity is therefore vital. Students going through a mental health crisis should not be placed on a months-long waiting list to access services. We recommend an independent report and review of CAMHS and better integration of mental health supports between the Departments of Health and Education.

I welcome any questions the committee may have.

Mr. Gary Honer

I welcome the opportunity to discuss mental health supports in schools and tertiary education at this roundtable discussion. It is a complex issue as the supports available to both students and staff are unfortunately quite varied.

According to a recent report in The Irish Times, a study by Maynooth University, National College of Ireland and Trinity College Dublin found more than 40% of Irish adults have a mental health disorder. However, the people most likely to have a mental health disorder were younger and likely to have suffered a traumatic life event.

In respect of the members we represent, SNAs are specifically affected. When a traumatic event occurs in a school community the first response is the arrival of NEPS at the school. When NEPS leaves, however, it is the SNAs who assist the students in their times of need. Often, the traumatic event is compounded for these students by their additional needs.

We must have a holistic approach to tragic events, one that encompasses the entire community, including management, teachers, SNAs, secretaries, caretakers, parents and siblings. They all need to have access to a community-based mental health service as a tragedy is a tragedy. There must be a more structured approach. We have heard many personal accounts many months after a tragedy, up to eight months later. For example, when a student passes away, a student under the care of an SNA may pull out a book or toy that happened to be the favourite of their deceased classmate and that child is brought back to the grief and loss of their friend. While NEPS provides a valuable service, it unfortunately only deals with students in the moment and at a particular point in time.

It is vital that SNAs are given access to appropriate training and support that allow them to support the mental health needs of the students they work with. SNAs are often overlooked in this regard, which is unfortunate given the close bond and rapport that exists between SNAs and the students they work with. There is a lack of recognition for SNAs as a professional grade, for example, in comparison with social workers. Social workers have a defined career hierarchy and support structure, with senior and principal social workers, which encourages reflective practice and child-centred interventions based on the individual child's needs. Sadly this type of professional infrastructure does not exist for SNAs, but it should. Through the introduction of school-based mental health supports at primary level, there is an opportunity to strengthen and protect the mental well-being of children while also supporting their parents, teachers and SNAs. This could also lead to a reduction in the number of children who require specialist mental health treatment.

Staff members can have mixed experiences when dealing with their employers on the subject of mental health and well-being.

According to Mind, a UK-based mental health charity, more than one in five or 21% agreed they have called in sick to avoid work when asked how workplace stress had affected them; 14% agreed they had resigned and 42% had considered resigning when asked how workplace stress had affected them; 30% of staff disagreed with the statement, "I would feel able to talk openly with my line manager if I was feeling stressed"; and 56% of employers said they would like to do more to improve staff well-being but do not feel they have the right training or guidance.

As regards the Department of Education, while it has extensive policies on the well-being and health of children and young people, which are to be commended, for those policies to be realised it must support the workers who in turn will support the students and young people they work with on a daily basis. It has fallen to the trade union movement to provide employee assistance programmes to its members, whereas this should be provided as a matter of course by the Department for all of its staff. Furthermore, as I mentioned earlier, appropriate training and support must be afforded to special needs assistants who are working at the coalface in schools along with their teaching colleagues. However, a disparity exists in this regard as teachers can avail of extra personal days, EPV days, or as they are more colloquially known, "course days", whereas special needs assistants, SNAs, cannot. As well as that Mental Health Ireland only offer their “Mind-out” course to teachers and youth workers. The Mind-out programme that was developed by the Health Promotion Research Centre at NUI Galway and the HSE’s health promotion and improvement department has been proven to strengthen young people's social and emotional coping skills and improve their overall mental health and well-being. It is a question that Fórsa raises here today as to why SNAs have not been included in the roll-out of this programme?

Barnardos children’s charity who work with some of Ireland’s most vulnerable families have a saying that every childhood lasts a lifetime. SNAs want to support the totality of a child’s and young person’s development, but they must be given access to training and support to allow them to acquire and develop the skills to protect, nurture and support the mental health and the well-being of the students that they work with. The Department of Education needs to recognise the valuable contribution that SNAs can make in preventing poor mental health and ensuring that all of our children and young people thrive in the school community. I thank the committee for their time today and Fórsa are happy to answer any questions that the committee may have.

I thank Mr. Honer. I call Ms. Leydon.

Ms Moira Leydon

I thank the Chair. I am conscious colleagues that I am the seventh speaker in a row and, therefore, I will do what I will call a little mop-up operation and the committee has the Association of Secondary Teachers Ireland, ASTI, submission which they can consult for a refinement of the policies. I wish to make three remarks. Number one, we welcome the opportunity. I love that concept developed by Maureen Gaffney - "Flourishing". Well-being is something that is more than just an individual matter. Failure to flourish at school or college is never an individual problem it is a societal problem and as Maureen has said schools are the optimal sites for responding to mental health difficulties for young people.

We have not mentioned the extent of the problem and the prevalence of the problem around the table and I think it is important. Two major pieces of research are referred to.

In 2013, research by the Royal College of Surgeons demonstrated that by the age of 13, one in three children had experienced a mental health difficulty. By the age of 24, that had increased to one in two. It is clear that youth and adolescence are times when significant life and health challenges are addressed and that is the optimal time to intervene. As Mr. Honer said, recent research by NUI Maynooth found that young people aged 18 to 24 are eight times more likely to have mental health difficulties than the older population. It is a bit like the housing crisis talk about the "squeezed youth" they are really facing a barrage of life challenges. Of course, the impact of Covid-19, anxiety, stress, depression are beginning to surface and manifest.

We have not mentioned around the table, and I think it is kind of important, the extent of the problem and the prevalence of the problem. There are two major pieces of research that are referred to. First is the 2013 Royal College of Surgeons research which found that by the age of 13 one in three children had experienced a mental health difficulty. By the age of 24 that had increased to one in two. It is very clear that youth and adolescence are times when significant life challenges and health challenges are addressed and that is the optimal time to intervene. As Mr. Honer said, recent research by NUI Maynooth hsa found that young people aged 18 to 24 are eight times more likely to have mental health difficulty than older populations. It is a bit like the housing crisis we talk about the 'squeezed youth'. They are really facing a barrage of life challenges and of course the impact of Covid-19 anxiety, stress, depression are beginning to surface and manifest.

We are here today because committee members are legislators and they inform and make policy. I always think it is good to come with a shopping list because the committee needs to know how it can help given it is genuinely concerned about these social problems. From ASTI's perspective, there are a number of core areas that the committee needs to intervene in quickly. First, the committee needs to address the situation as regards guidance counselling in schools. Teachers are contracted to teach 22 hours, the allocation ratio for guidance counsellors in a school of 500 pupils is 18 hours so they are not even getting a full-time guidance counsellor.

The allocation ratio has to be changed in light of that as it has been around for the past 30 years. Second, according to research I picked up this morning from the Institute of Guidance Counselling that they conducted this year, in 10% of the schools they surveyed the guidance counsellor was not practising as he or she was too burned out. Some 22% schools had unqualified internal staff filling the role and 26% of schools had external advisers coming in to fill the role. We have a crisis in the guidance counselling service that has to be addressed.

The other crisis is in area of the child and adolescent mental health service, CAMHS. CAMHS is a brilliant service if one gets into it. It is a bit like the health service. The waiting list is absolutely critical. We have waiting lists for up to 18 months. That is completely not the way to sort out the problem of a child with a mental health issue. There is also the variability across the regions and there was a dreadful incidence of other issues in the service last summer.

I like to think politics works and I was impressed by the way this committee heard from Dr. Paul Downes from the Dublin City University, DCU, Disadvantage Centre last year. He made a compelling case about the need to supplement the guidance counselling service in schools with emotional counselling and therapeutic supports to address the mental health issues manifesting among young people. I urge all Oireachtas Members to look at Dr. Downes's 2017 research on a sample of young men who are homeless in Dublin and the reasons for their homelessness and as someone who works for teachers and is very proud of our education system, how they fell through the gaps in the system at second level. It is truly sad but can be remediated and I urge committee members to look at that and at the recommendations he has in it.

Mr. Duffy had made the point in respect of school leadership that we need more posts. Teacher training is essential and we have a further crisis in teacher training in that teachers are now not able to get a day out of school to go to necessary training because of the supply issue. When these crises are not addressed, they become much more complex to solve.

Mr. Jones addressed a topic that is under-addressed when we talk about well-being and mental health, which is the whole area of teacher well-being. The 2015 guidelines for well-being in the junior cycle make the point that student well-being starts with staff. They are on the front line of the work and it is hard for them to be genuinely motivated to promote emotional and social well-being if they feel uncared for or burnt out themselves. Perhaps this is an area the committee may wish to look at into the future. We need to address the issue of well-being among our teaching workforce, including at third level. It is at a really serious level. Naturally I would have lots of other things to say but I will conclude on that. We did not get around to curriculum, which is a vital area for intervention for youth mental health but we are not just here to talk; we are here to listen and to respond to the committee.

I thank Ms Leydon. The first questions will be from Deputy Ó Laoghaire followed by Deputy Ó Ríordáin if Senator O'Loughlin or Senator Joe O'Reilly are not here.

Gabhaim míle buíochas leis na finnéithe. Táimid an-bhuíoch as an deis caint leo. Is fíor go bhfuil géarchéim inár gcuid scoileanna ó thaobh an brú atá ar ár ndaoine óga. The mental health pressures faced by young people cannot be dealt with in schools alone. There is no question of that. The pressures they face come from all aspects of society and we could have a big discussion about whether it is the loosening of the binds of community, the pressure of exams and whatever perceived success is, all kinds of other things and social media. This is beyond the remit of the committee but the fact is our CAMHS system is so profoundly under-resourced and struggling so badly. To give an example that I think the speakers will be familiar with it but for anyone listening in who is not, I have come across instances where there are young people who are self-harming but are believed to have inadequate suicidality to be admitted to CAMHS. That is a person with a severe crisis who is very much at risk and cannot access CAMHS. That is the situation we have and it is important to put that on the record.

There are challenges and pressures but we do have opportunities in schools. Every child should be attending school so there are opportunities there and a lot of good work happening.

There are challenges and pressures that go with schools but we have an opportunity. Every child attends or should attend school so opportunities are available. A lot of good work is happening and is welcome.

This is not a question. I agree with the point Ms Hughes made about the inequality that exists for educational psychologists. That needs to be addressed because a lot of labour by educational psychologists is not being adequately recognised or properly supported. I also agree with the point Mr. Honer made about SNAs not having the flexibility or opportunity to take additional days. My questions are primarily for the INTO and the ISSU.

I will ask the INTO about the new programme which I welcome. Has there been any engagement directly with the INTO about how this will be rolled out and what it will look at or are we at the early stages?

Dúirt Máirín rud éigin faoi féachaint arís ar conas mar a dheantear cur síos ar phobal sa comhthéacs seo. We talk about re-examining and redefining community in this context. What does Ms Ni Chéileachair mean by that? Will she flesh that out? I am conscious that dealing with mental health in schools is not only about crisis intervention and counselling. Is there any scope for early intervention or emotional well-being resources or do those perhaps exist? I am looking at the time and conscious I need to allow some for responses.

Ms Foley is the person here representing those currently in the school system. There are already many excellent guidance counsellors. Will Ms Foley give the committee an insight into the experience of the members of the ISSU of how the guidance counselling system is working and perhaps where she feels it is not working?

I ask Ms Leydon of the ASTI to expand on the point made as to why this is not being considered for the post-primary sector. Guidance counselling is available at post-primary level but that is perhaps a different animal from what is being talked about in this pilot.

I will leave it at that. There is plenty to respond to in that. I ask the three witnesses to respond.

Ms Máirín Ní Chéileachair

There has not been any formal engagement with the INTO to date on the pilot programme. That is the short answer to that question. We look forward to it.

I will flesh out an choncheap faoi phobal. When we engage with the special education section and others in the Department of Education and look for services to be co-located in schools we are told that Government policy is to provide services by the community, in the local health service or via GP practices. My experience as a primary school teacher and as a principal is that if we had something co-located in schools children who are at huge risk are more likely to engage. Most children come to school every day. Their parents bring them to school. It is valuable for an at-risk child and an at-risk parent to have somewhere they can come to do both and where the child does not have to be moved out of the building. There are models of good practice from the UK, Iceland and other countries where we have seen this working well. We would like to re-examine the concept of community. For many pupils community is the school. The school is at the centre of the community in many rural areas. Our official definition of community is too narrow in this context. The school should be central to that definition of community.

There are certainly many programmes running in schools that are hugely beneficial. We are at an exciting stage of the development of a new curriculum at primary level and there will be opportunities under the wellbeing specification and a lot of good work will be done, but a therapeutic service cannot be replaced for a child who needs it. Teachers are not psychiatrists, psychologists, counsellors or therapists and while they can create, as I was told 40 years ago, an atmosphere of psychological safety in their classroom, they cannot recreate a therapeutic setting. They need support to do that.

Ms Anjelica Foley

The provision of guidance counselling in schools varies, as my colleagues pointed out previously. Guidance counsellors have different working hours. Not every school has the same capacity for students to be able to talk to their guidance counsellors about their mental health because the role of guidance counsellors is primarily to offer students guidance they need and they simply do not have time. It is difficult to get an appointment with a guidance counsellor. I know that from my own experience as a student. That lack needs to be addressed.

Ms Moira Leydon

I do not see any logic to the Minister for Education not extending it to post-primary. It is almost a default mechanism to do a pilot. The problem is that our experience of pilots in this country is that they can last for 20 years. We are a bit cynical. I am sorry; it is never a healthy political attitude to have. We will call on the Minister to extend it. I referenced the prevalence of mental health difficulties. Adolescence is the prime time for these difficulties to manifest. If we are not in a space where adolescents can get early intervention and support, that is a failure to help because that is when they need it. They also need it later on, but getting in there now we have remediation, as distinct from dealing with a much more serious problem. We will be going formally to the Minister for Education and talking about the model and what the plans are for second level.

Going back to Dr. Downes's work, the key points are not that radical. They are about the transition from primary to second level, the gaps that exist and the staff in schools being unable to deal with challenging behaviour. Therefore, there is a vicious cycle of suspensions and expulsion. They are also about students who have no self-belief or self-esteem and therefore are poor learners and failing. Many of these issues can be addressed with appropriate resources in schools. We come before the committee all the time and we say that we want more resources, but this is the nub of the problem. There is an under-investment in schools. Teachers are not mental health workers. We are not putting other professionals in place in the school setting to address the holistic needs of young people. I am paraphrasing what Ms Ni Chéileachair said.

I thank all of the speakers for coming. I will make some comments before Ms Foley expands on some of the issues she raised. Much of what she said has resonated with many of us here. The Irish education system is almost uniquely set up to have mental health challenges within it. We separate children on the basis of religion and income and we separate them more than any other European country seems to. From my own experience, I know that children are coming to the school gate hungry and possibly having not slept the previous night or witnessed things that they probably should not as children and then facing the scenario of an oversized class with a teacher trying to balance all the needs of those children. We have one of the largest class sizes in Europe. It is coming down however and that should be acknowledged. It is a reality in the classroom. The SNA, as Mr. Honer rightly said, is under-appreciated in the system and is struggling for respect. There is an absolutely traumatic change at the most vital time, as Ms Leydon rightly said, in their formative years when going from the primary school setting to secondary school, with a complete change in the ethos and the exam-driven atmosphere. You are trying to tackle issues like homophobia or transphobia in a school. You have to worry about what the patron body has to say about those matters because we have a disproportionate number of schools under religious patronage.

Ms Foley made a point about the new junior certificate being a welcome development. The resistance to that change was something the Department had to grapple with. When we speak about leaving certificate change, I hear resistance to that and a determination to go back to where we were. Within all of that we must pay tribute to teachers, SNAs and those working in schools who do their absolute best to mind the mental health of the students in front of them. There are gaps between what the HSE provides and what the Department of Education provides. Often, children fall between those gaps.

I would like to focus on one thing with Ms Foley, namely, exams at second level because many issues have been raised. There is a focus on exams. The teacher has 40 minutes to deliver the programme and there can be pressure from parents about what the teacher is doing and how the targets are being met. Everything seems to come down to the junior certificate results and then, of course, the leaving results and the pressures associated with that.

Can Ms Foley expand on that and maybe feed into what we all hope, certainly from my point of view, will be a changed leaving certificate and a changed system at second level that allows the space for a young person to be themselves and not to fit into this very rigid old exam that suits some people? Of course, one knows that people that it suits tend to make the rules when they move on from second level but those who it does not suit do not tend to make the rules. Can Ms Foley expand on that and use the opportunity the committee presents to tell us from her organisation's perspective how she feels the exam system impacts on mental health and how it could be changed?

Ms Anjelica Foley

I thank Deputy Ó Ríordáin for his question. It is really important that I frame my response in light of the current situation of the leaving certificate. I sat my leaving certificate this summer and, as I am sure the committee is aware, all of us here have sat our exams. At the moment, due to the pandemic and the changes, it is more stressful than ever. Students, whether they are high or low achievers, are always stressed. Right now there are students around the country who scored maximum number of points and still did not get the places they wanted. They still did not get their first choice. Can one imagine the stress those students face? Can one imagine the stress a student faces when it comes to the Central Applications Office, CAO, and waiting for those results as well as for junior cycle students who until last week did not know when they would get their results? Exams will always be stressful but there is so much we can do to make them less stressful. It is really important that we do not just consider the students. It is also really important that when we are making these changes, we speak to the teachers too. In Ireland we have one of the best education systems in the world and it is not just because of what we are teaching students but because of the relationships that teachers and students have. Students and teachers and the pastoral care system mean that students can build a real connection with their teachers and vice versa. That is really important with mental health supports, that is, that students can trust their teachers and vice versa. Reform is important but it is really important that when we talk about reform, we talk to everybody to encourage positive change so we do not have to reform it again so drastically in 20 years' time.

Does Ms Foley find at second level that the exam pressure is there from day one until the day one leaves and that it is unreasonable?

Ms Anjelica Foley

That is fair to say for students when one thinks about the leaving certificate system. For example I sat leaving certificate history and it is a very stressful exam but at the end of the day, it is a terminal exam-----

I am still traumatised by my leaving certificate history exam.

Ms Anjelica Foley

It is a terminal exam and if one looks across the globe, we have made submissions about leaving certificate reform but even the United Nations Committee on the Rights of the Child stated that we needed to reform it because it causes too much stress and places pressure on mental health.

I call Senator Pauline O'Reilly who will be followed by Senator Flynn.

I thank the witnesses for their opening statements which I read in detail. I want to focus on two things. The first is the resources. It is important that every time witnesses come before us that they raise the importance of resources so that it gets into our reports. Nobody wants to hear that schools are not funded enough and that teachers do not get the kind of training they need.

The second thing is training. There was a real call for further training for teachers from today's witnesses and the witnesses who came before the committee last week. That has come through loud and clear from all of the opening statements today. I have come from a National Women's Council briefing on education around relationship sexuality education, RSE, and healthcare. The call there was for further training and professionalisation for social, personal and health education, SPHE, teachers, for instance, in order to be able to deliver what is now quite complex. Society has become really complex and young people are dealing with that. As Fórsa pointed out in its opening statement, 40% of adults have mental health challenges and that starts out somewhere. That starts when people are really young.

Do witnesses think it is about focused teacher training for some subjects like SPHE or do they think it needs to be across the board?

As I said last week, teachers are sometimes a little like GPs. Everyone comes to teachers although they might not be the people qualified to deal with a particular issue. They are the conduit to send people in the right direction. Should mental health training be provided to all teachers?

Second, I will focus on the lack of services for teachers to direct pupils to. It is all very well to understand that someone is experiencing a mental health crisis but everyone in this room will recognise if there is no one for teachers to refer pupils to, they will be left carrying the can because of the relationships they build with young people. I welcome any thoughts the witnesses might have on that.

Dr. David Duffy

What I will say is similar to some extent to my answer to Deputy Ó Laoghaire's question earlier.

The three main issues the Senator hit on are vitally important in the area. One is being able to access CAMHS and adult mental health services as we are also talking about tertiary education. Any comments I make of CAMHS, adult mental health, NEPS or any other service, is not the fault of the staff. They are simply dealing with waiting lists that are utterly unmanageable, but timely referrals are needed.

Pastoral staff in both colleges and schools are vitally important as the Senator rightly referenced. We have many reports of guidance counsellors in schools doing a fantastic job often in difficult circumstances. My colleague from the ASTI mentioned that some schools do not have a whole-time-equivalent guidance counsellor. Many cases are referred to us of guidance counsellors holding on to students who have levels of need that the guidance counsellor knows she or he cannot manage. There is nowhere to refer the student to so it is the case that holding on is better than doing nothing. This is not a criticism of the staff in NEPS who do a fantastic job but they are swamped. NEPS staff members need to be on the ground with individual students. A trickle down model serves a purpose but it does not solve the problem.

Third, as the Senator stated very well, training needs to be available to all teachers. There is a teacher supply crisis and releasing people for training will be difficult but it must be available to all teachers. Continuous professional development, CPD, is vital, but no matter how much CPD we do in this area, teachers will still not be psychiatrists or psychologists. In the past few days we encountered an issue about assessment of needs. No matter how much training teachers do, they will not be occupational therapists. Therefore we still need to be able to refer students to experts and as many services as possible need to be close to schools so students can be referred, but I must re-emphasise that services must be available in a timely manner. Telling students that the local service will help them in 18 months time is not ideal.

Ms Máirín Ní Chéileachair

At primary level we have a generalist rather than specialist model. I made the point the other day to someone that initial teacher education takes between four and six years depending on which model a student follows. Some people are in a classroom for 40 years after qualifying. We must provide our teachers with CPD. It should be available at all stages of their careers, kept up to date, based on best practice and on evidence-based models. I reiterate what Dr. Duffy said about needing specialist help. Schools and teachers cannot solve all of the ills of society. We must have services. The INTO ran a webinar recently with CAMHS about mental health services and resources that are freely and widely available, but almost nothing is available for children under 12 years old.

Mr. Gary Honer

I thank the Senator for her questions and for reading over the submission as well. First, the earlier the intervention, the better the outcome. The earlier that the intervention is made and the younger the child is, the better the outcome will be.

I am here to represent my members who are special needs assistants, SNAs. Training needs to be provided for SNAs as well as for our teaching colleagues. It should be provided for all colleagues in the school setting. As I said in my presentation, this is not a criticism of Mental Health Ireland, but it is just a fact. If one goes on to Mental Health Ireland’s website to access the MindOut programme, there is a tab for teachers and a tab for youth workers, but there is no tab for SNAs. SNAs should be able to avail of the training if they want it. If they are armed with that skill set, they will be better equipped to deal with students in their times of crisis. I would agree with the Senator completely in terms of training. That needs to be provided to all colleagues in schools - not just teachers, but SNAs as well.

Ms Máirín Ní Chéileachair

Under Sharing the Vision, which is the new vision for mental health services, the implementation plan specifically makes that recommendation that all teachers will have access to training. This is actually in the plan. However, making the plan work is the challenge.

Sharing the Vision is just this nightmare in my head at the minute. Anyway, moving on.

It is always important for people who have experience, even as a politician or whatever, to draw on that experience and say that they know what they are speaking about. When I was just 11, I was in a very bad accident. I lost my mother a few days before that accident. There were no supports around counselling or trauma in school, which led on to some anxiety and depression that still exists today because it was not dealt with when I was a young person. Those supports are well needed for young people today. In one sense, we are moving as a society because of the teachers, the SNAs and the professionals that we have now within our education system, who see that we should not be taking part in shaming people with mental health and trauma issues.

I know that in its investment for the budget, one of the INTO's recommendations was to invest in mental health. We are doing much talking around mental as a society, but we are doing very little action around young people and mental health. Again, we talk about some of the organisations. Some areas such as Ballyfermot, Crumlin, Inchicore and Cherry Orchard do not have the same level of mental health services as other more upper-class areas, if you want. I am aware that mental health does not have a class. However, there are different levels of pressure around people from, say, communities such as mine, namely, the Traveller community from Ballyfermot.

One of my questions is directed at Fórsa and the INTO. Would it be fair to say that DEIS or disadvantaged schools would need more mental health services than non-disadvantaged schools? The SNAs are lifesavers to a certain extent in our schools. Sharing the Vision states that the training is there for teachers. For example, if there is a young child in a wheelchair in a school, he or she has an SNA. The SNA is the carer and educator. They take on so many roles, as well as the teacher. It is important that we include our SNAs in the training. There are so many different levels of training that are expected for our teachers, for example, training in Traveller culture, other cultures and mental health. SNAs are carrying out the job on very low wages as well. They did not go to school to be professional psychologists; they went to be educators. There is a difference. That was the one question about disadvantaged schools.

I have a question around the barriers of being diagnosed with a mental disorder or any kind of disorder that young people would have in primary or secondary school.

What kind of positive impact would a diagnosis at a younger age have on a young person's life? I am sick to the teeth of pilot programmes that do not work or even if they do work, do not get implemented. I know the witnesses have the answers but how do we implement those answers? It is not about reinventing the wheel. We are not geniuses saying this is what we need to do. The answers are already there. Obviously, money is a big part of it. How do we turn them into actions?

Mr. Gary Honer

I thank the Senator for her comments and her support for SNAs. As someone who went to a DEIS school - I am from Crumlin - it would be an established fact that there would be a significant increase in mental health issues in DEIS schools. That is an established fact.

Recognition for SNAs as a professional grade is something Fórsa feels very strongly about and it has been campaigning on this for quite some time. In respect of the comparison in my presentation to a social worker where there would be reflective practice, this is something we have been campaigning on for quite some time. I thank the Senator for her comments and support for our members.

Ms Máirín Ní Chéileachair

The INTO has always supported extra funding for DEIS. If extra funding and resources were put into all schools, we feel it would correspondingly happen in DEIS also. I taught in a disadvantaged area so I realise the problems that are there. SNAs are our colleagues in schools. We work with the same children during the day every day. The partnership there is really strong. I would support Fórsa's call for the same access to CPD and training. It can only improve what is happening in our classrooms if we all operate as co-professionals in that space.

Mr. David Duffy

I thank the Senator for her question. We need support inside and outside the education setting and we need CPD. In a quote from a European Commission report a few years ago, a lecturer stated that a student emailed them 11 days on one day because the student had nobody else to talk to. That is the day-to-day reality with which staff in education settings are dealing. They need support.

I thank the witnesses for their presentations. We hear them time and time again. We cannot hear them often enough but very little happens in terms of implementation. It is frustrating from our point of view so it must be frustrating from the witnesses' point of view when they see so little movement yet they present all the solutions here today. We do not need enormous reports or pilot projects. Like everybody, I am tired of pilot projects. It is not just a case of me being tired of them, it is the money we waste when we do not use what we learn from the pilot projects. It is very frustrating when there is no in-built evaluation and streamlining of those projects. I have been involved in some of them around mental health, bullying and other topics and I think we need to think long and hard. I know it is an attractive proposition if somebody gets some money to do a pilot project but I wonder whether we are all colluding in keeping things where they are. Those were some of the ethical questions - even for myself - around working in community development. To what degree were we colluding in that system?

My first question is directed to Ms Behan. Obviously, the solution is core funding. Core funding in third-level education has to be fixed. It also relates to what Mr. Jones was saying about staffing as well but without the core multi-annual funding, we are just not going to fix this problem. There is no skirting around it.

While it might be politically expedient to announce one project or one pilot project after another and to get the headlines for a couple of days and then go off on our merry way, if we do not fix what is under the bonnet then we are not going to fix this at all. When Ms Hughes said that there was "standing room only" on the waiting list, how many of those people standing there could not wait or did not wait to get the supports and services they needed? We are dealing with people's lives here, as all of the witnesses know.

Ms Hughes said the total funding for on-campus mental health supports was €5 million in 2020-21 and again in 2021-22; for the past three years, the mental health budget has stayed the same. However, €3 million is announced each year as additional funding. There are figures being played around with, which is nonsense. That needs to be called out. We are a cross-party committee. Mental health for young people is more serious than any political party on its own. We need to call it out, whether within our own parties or whatever to stop this from happening. While the ability to announce the funding each year as if it is new money is politically beneficial, how disruptive is it to providing a proper service on-campus when they cannot be planned properly and organisations do not have the resources on a year-on-year basis?

Ms Sarah Hughes

I thank the Deputy for her question. It is exceedingly disruptive. The money that was provided last year for Covid-19-related additional supports went unspent in a number of colleges for one of two reasons. First, because it was one-time funding, only a year's contract could be offered. There is a dearth of people who can apply for these jobs and that is not an attractive job posting. It is hard to fill a position like that. On top of that, many campuses do not have space to ad hoc hire two or three more counsellors for a year and then have them go off again. That was a situation we were faced with last year. Regarding the campus I referred to where there was standing room only on the waiting list, the head of counselling there told me they have two sessional staff they do not know if they can keep on beyond the end of November. If that happens, they have five staff, I think, so that is almost half of their staff gone. That has an obvious knock-on impact not just on the number of students that can be seen but also on the roll-out of things like the national suicide prevention framework. It does not have a specific staff member allocated for the roll-out, so it falls onto staff like counselling staff, who have to juggle their session loads and the roll-out of multiple frameworks at this stage. To sum up-----

The provision in itself creates anxiety. What impact are the challenges of student accommodation and the financial pressures having on mental health? Will Ms Hughes describe that?

Ms Sarah Hughes

The college experience for many students is a melting pot for mental health issues. It is a pivotal time of life. There are a number of risk factors for every student. When financial pressures are added to students having to get perhaps multiple jobs or accommodation issues leading to students having to commute ridiculous amounts of time or register as homeless, which some students are, that places an untold amount of additional pressure on their mental health and on mental health services that are overstretched. We also see that students are reluctant to seek that help because they know the waiting lists are so bad. They say to themselves, "I was able to stand up out of my bed this morning so there is somebody worse off that needs that slot so I will not seek the help myself."

Go raibh míle maith agat, a Chathaoirligh agus cuirim fáilte roimh na haíonna uilig. Gabhaim buíochas leo as ucht an méid atá ráite acu. I thank the witnesses for their submissions and presentations.

I endorse various things I heard, including what Mr. Honer said about the important work and role of SNAs and the need to put more structure and recognition into their situation. I will especially mention what Ms Foley had to say about the stress caused by the leaving certificate examinations and I will speak about that in a moment. I also endorse what Ms Leydon said about pastoral supports and the role of guidance counsellors and what Ms Ní Chéíleachair said, which was also a point made in the INTO submission, about family and marriage breakdown. That is an issue that needs to be talked about. There is a crisis in that area and in our society, which lies behind much of what we are talking about today. We do not speak about it often.

I will begin, however, with the issue that worries me most, namely, the Maynooth University study that states that 40% of Irish adults have a mental health disorder. If we really believe that, I wonder if any amount of resources can deal with the problems we face because that would be indicative of a society in a state of breakdown. We advert to these statistics, as we should, because they are published by researchers. We need to interrogate that figure and what it means for our society. I read up a little on it and it states that insomnia is one of the main issues. How long can a society continue to function if 40% of people have mental health challenges?

I mentioned to the group who attended the committee meeting last week that while I support and endorse the various calls for resources, I ask people to focus on whether changes to the system can help. I would be grateful to hear the witnesses' views on whether, given the shortage of experienced staff in the system, including in psychology, speech and language therapy and medicine, the shortage of people available to work in Ireland will bedevil the entire effort no matter what resources are in place. Would the witnesses support a policy that reserved 50% or 60% of college places in the areas of psychology, pharmacy, speech and language therapy, medicine, etc., for people who are ready to work in Ireland for a defined period? That is the kind of serious measure that is needed. Is that something that is under discussion? Is it on people's radar?

Ms Sarah Hughes

I can speak from the perspective of a psychology graduate. When we consider clinical psychology in particular - because that is the one being funded - there is a bottleneck. Many undergraduate psychologists would love to go on to study for specialist qualifications but the places are not available due largely to funding issues. Although clinical psychology training is funded, only a small number of spaces - I believe there are approximately 36 in the country - is available. It was even harder for undergraduates to access those courses that were not funded until the recent budget as they had to self-fund. I know the Psychological Society of Ireland feels the same way. Many undergraduate psychology students have to move on to different career paths because they cannot access specialist training. The solution is less about reserving spaces and more about increasing spaces.

Ms Hughes believes the problem is not just an exodus from Ireland but rather people getting through the system in order to train. That might apply in that area, but perhaps the question remains valid for other areas or even in that area to some degree.

Ms Moira Leydon

I am not sure whether I understand the policy the Senator is proposing but certainly my instinctive or political reaction is that many graduates are leaving Ireland because of the socioeconomic situation. Graduates tend to be young people. They cannot get homes. We have a crisis of supply and affordability and therefore emigration is exerting a pull. Over the generational cycle we see it operating in a defined sense. There has been discussion in the media recently about the number of health graduates emigrating. It is a complex issue. We need to know more about why they are emigrating. Why are conditions in our health service seen as so unattractive that they lead people to decide to emigrate?

We have not given sufficient support to the national plan for equity of access to higher education which is now in its second iteration.

We tend to base our projections for entering into higher education on school leavers but as a society, particularly for the human sciences like the therapies, health, social services etc., we need to see how we can encourage more workers who have experiential knowledge of problems in real-life settings to go into further learning, particularly at higher education level. It is very expensive, particularly if you are not earning and have a family to raise. While I would perceive there being a problem out there, we need to see what are the pull factors, including those of other economies and jobs, and what we can do as a society to make sure we get more people into these jobs. The Minister, Deputy Harris, made a successful pitch recently - he said we should stop looking at school leavers going into third-level education as a solution to all of the skills problems in this country. We need to start thinking about other post-school destinations in order that people have a spectrum of skills and life experiences and can then, if they wish and have sufficient financial security to do so, move on to third level. That is my trade union reaction to the question.

Mr. Frank Jones

I thank the Chair and the Senator. I will be brief. The Irish Federation of University Teachers does not have this discussion about reserving places for particular professions or restricting access to particular courses. We would like more courses, places and employment and better conditions of employment. This would cause a difficulty. Our view on universities and university education is that it is not a development ground for particular professions or employment; it is much wider than that, as the Senator knows. While we do not discuss the suggestion of particular courses geared directly towards employment with restrictions then on progressing or advancing or on leaving the country or that sector, we would not be in favour of such a proposal.

I thank the witnesses for their attendance and for their submissions. It is important to recognise that society has been imposing extra responsibilities on teachers and educators over the past 20 to 30 years. I acknowledge that although the witnesses recognise they have an important role in identifying mental health challenges children and young people face, they emphasise they are not qualified medically to respond to that appropriately or in the way the student requires. I commend them on appreciating that mental health issues can arise and generally do, as Ms Leydon said, in people who are adolescents. It is an unusual illness in a way. Most of the time, illnesses are encountered later in life, but with mental health, it appears that many young people encounter it in their adolescence. I commend the witnesses on appreciating and acknowledging that they have a role to play, albeit not a clinical one.

Mr. Honer referred to the MindOut programme operated in Galway in his submission. I want to look at this because it appears to be a preventative mechanism, as opposed to treating people who have a mental health issue; this is a process of trying to make them more resilient. How does it operate? Does Mr. Honer think it is something that should be recommended more broadly?

Mr. Gary Honer

It is something that should be recommended more. I thank the Deputy for his comments. The programme arms staff with the skills necessary to identify issues as they arise. When you go on the Mental Health Ireland website, there is a tab for teachers and a tab for youth workers.

What is the programme?

Mr. Gary Honer

It is a programme to arm teachers and youth workers with the skill set to identify and talk to young people about mental health problems they are having and to de-escalate issues as they arise. It aids them in terms of de-escalating a situation; pointing them in the right direction; getting them on the road to recovery and making them well. As is said often, it is okay not to be okay. That is what it is about, as well as arming staff with the skill set to be able to de-escalate the-----

When Mr. Honer said the "objective", I note in his submission that the objective is to improve the coping skills of young people.

Mr. Gary Honer

Exactly.

Does Ms Hughes think that is important in a student context?

Ms Sarah Hughes

Most students have good mental health literacy overall when they get to third level. We did a pilot project with Jigsaw the year before last which indicated that but the transition to third level adds extra things young people have to cope with and often they are doing so for the first time without family or parental support. Many have moved across the country or from a different country and might need to adopt new coping mechanisms.

What is the appropriate age that Ms Hughes recommends we try to inculcate stronger coping mechanisms within younger people?

Ms Sarah Hughes

There is no particular appropriate age. It should start as early as possible and continue throughout the education cycle.

As Ms Foley is more acquainted with secondary students than the rest of us here, does she believe something can be said for trying to make secondary students more resilient or to teach them how to cope better with the stressful situations we will unfortunately always encounter in life?

Ms Anjelica Foley

I thank the Deputy for his question. Resilience is very important. When we consider the factors that contribute to mental health difficulties for students, it is interesting to look at students with enduring mental health. By that I mean students who have not encountered a mental health difficulty. There are many factors at play. When we look at schools, we should consider them not only in an educational context but also in the context of other experiences of schools, which can lead to students being more resilient in their mental health. Factors such as sport, being on the student council and the friends a pupil makes at school are all part of the support circle that will build resilience. That is important because we cannot focus on trying to stop students developing mental health difficulties without trying to actively address the cause. That is crucial if we want students to have positive experiences in life and not develop severe mental health difficulties.

Would Ms Ní Chéileachair like to come in on that?

Ms Máirín Ní Chéileachair

There is no minimum age at which we can start to build positive mental health. One of our issues, and Ms Foley referred to it, is that only one post-primary school in five is delivering an SPHE curriculum. In primary school, we have 30 minutes per week dedicated to SPHE. That will change in our new curriculum framework. We can certainly build on skills and give skills to the children and pupils in all our classrooms. We can probably save people from waiting lists they do not need to be on by using other interventions but that still does not get away from the fact that services do not exist for people who have a mental health difficulty which cannot be coped with in the normal circumstance of life.

I thank the witnesses for their detailed submissions. I welcome that we have been able to bring so many of the representative groups and unions to speak to the committee about mental health.

A number of the members of this committee also sit on the education committee and like me, on the mental health committee, which is a brand-new sub-committee of the health committee. We see many concerns being raised, especially during the two years of lockdowns during the Covid-19 pandemic. I have a few questions which I will pose and hopefully allow some time for a short response.

I agree with a point mentioned by the witnesses in their submissions that the transition phase is crucial, especially going into first class, first year and from secondary school to third level. I agree that transition period is a huge issue and note that Ms Leydon of the ASTI also mentioned it.

I have a few questions about the summer programme. It is about the investment we are now seeing coming from the budget into education. Some €9.6 billion is going to education with almost €2.6 billion going to special education. We will have almost 40,000 new staff, that is almost 20,000 SNAs and almost 20,000 special education teachers coming into the system. Mr. Honer is representing SNAs at the committee. I want to see the courses that UCD is rolling out being rolled out around the country. We will tackle getting 20,000 people their well-deserved qualifications. That has to happen. The Minister is aligned with how we see that being rolled out. As I represent the Roscommon-Galway area, I want to see much of it in the west.

I refer to the number of people who are coming into the school system and how that has been managed as a teaching staff. There is a cohort of teaching staff working with the special education teachers, including the mainstream teacher in the classroom and the SNA support. I would like to see it being more streamlined and I see that in schools I deal with in my area on that level. Does Mr. Honer have any more comments on that?

I might ask our guests from the ASTI and the INTO some questions about the summer programme. We have just announced funding on that and we are seeing one quarter of schools taking part. I have contacted schools in my area and I have good feedback from a number of principals about the impact of those two weeks, particularly for those schools. Are there any other challenges? We have a budget and we have this extra capacity coming to schools. They have also opened up the possibility that student teachers and different cohorts could be involved. Will we see anything with schools coming on board this year? It would be great to see a real increase in that. Are there any other challenges in that which we need to be conscious of? That bringing students in over the summer period helps with the transition piece.

The funding models, pilot programmes and so on are crucial because most initiatives we see come from pilots. The initiatives we have seen at third level came from pilot programmes. We are seeing technological universities being rolled out, which has been amazing in delivering excellence to the regions. We have spoken about mental health supports here but we have to look at how we deliver health in a different way. Much of this is now coming through telehealth and is being accessed in a virtual way for early intervention. We need to look at changing how we deliver healthcare at an early stage sometimes. I would be interested to hear comments on that as well, because the 50808 text number is a 24-7 one that is crucial for anyone going through anxiety or any type of stress.

The changes we see in the roll-out of the leaving certificate programme are something else we have been fighting for. It should not all be pinned on one exam and that does not deliver for all students and for all capacities and capabilities. We have the action plan on bullying and this committee did a report on that, which was one of our first reports. The Minister for Education has taken on board a number of elements of that. There has also been €5 million rolled out for that for primary schools. There has been an increase in NEPS with about 54 more psychologists coming on board in that.

My questions begin with the summer programme, particularly the transition and how we increase the number of schools taking on that programme this year when we have the funding available for it. I also invite comments on the engagement with CAMHS and community teams that has been mentioned. How do we set up a structure where the secondary school system can engage with our new disability teams in the community space, particularly in the community healthcare organisations, CHOs? On the counselling supports and the action plan on bullying, each school has an ethos and parents sometimes have to look at what the ethos of each school is. In the inspector's annual report, reference is being made to how bullying is being managed in each school. With this new recommendation from the action plan, we will hopefully see this. What are the witnesses’ comments on that? How will schools engage in that action plan on bullying and how will they manage it? These are the matters I see as being of interest. I might start with the transition and I invite Ms Leydon to speak on that from ASTI's point of view. Mr. Honer might come in on the SNAs.

We might discuss that briefly because I am conscious that we have to suspend to bring in the next group and that we have to be out of here by 2 p.m.

Ms Moira Leydon

I have to defer to my INTO colleague because second level is not the dominant space where the July provision is provided.

Can I ask Ms Leydon if secondary schools cannot provide this or why secondary schools will not provide this?

Ms Moira Leydon

It is not that they will not provide it but the facts of the matter are that many of the students whose parents want them to attend the July provision will be students with significant disabilities-----

I do not think it is just-----

Ms Moira Leydon

-----and quite often many of those students would not be in the second level system.

I disagree to some extent. There are a number of schools and we are seeing that one in four schools that access supports are DEIS schools. They are not just accessing supports for numeracy and literacy but for supports: to engage with this transition period; in well-being; in communication; in isolation; and in all the challenges we have seen over the two years of lockdown that we have all spoken about today. Therefore, why do secondary schools not want to take on the summer programme?

Ms Moira Leydon

We may have a misunderstanding of terminology. When we talk about July provision-----

Or the summer programme.

Ms Moira Leydon

-----we are talking about fairly dedicated July provision for students with significant levels of special educational need.

It is what we might call a supplementary education programme. It would be fantastic if more second level schools put them on. There are two reasons they do not. The first is because it is difficult to get qualified staff to engage with them-----

There was an early announcement this year. I am aware that it is a challenge but compared to last year there is an early announcement this year, which came in the last month, about the summer programme. The name has now changed. How can we support second level schools to engage in that programme? We now have an early announcement, we have the funding, and it is opening up for students at other levels as well including for third level for graduate teachers, and also in other areas such as therapy and healthcare and so on. There is a real opportunity there.

Ms Moira Leydon

It is a very practical measure. With regard to the timeframe, the first thing to do is to talk to management bodies. They are the people who make the decisions about the school opening, about putting on programmes, and so on. I do not mean to be dismissive but I would say that is exactly what I would----

But we will have the ASTI support?

Ms Moira Leydon

Absolutely.

That would be great.

Ms Moira Leydon

But there must be a very frank conversation with the management bodies around what they perceive as the difficulties.

There seems to be very good feedback from principals around this programme, so I am curious about that. I thank Ms Leydon.

I must cut the meeting short. I am genuinely time constrained. I thank the union officials for coming here today. The discussion was very beneficial for all of the committee members. Another group is due to come in, from the State Examinations Commission, to discuss the delay in the junior certificate results being published. Normally we would have had a three-hour meeting, but unfortunately we could not afford that here. I thank the officials for coming in.

Sitting suspended at 12.56 p.m. and resumed at 1 p.m.
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