Pearse Doherty (Donegal, Sinn Fein)
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Tá fearg an phobail intuigthe mar go bhfuil an Rialtas seo ag caitheamh €9 milliún ar phúitsí gutháin in áit tacaíocht mheabhairshláinte do pháistí. Tá daoine óga ar fud na tíre seo ag caoineadh amach ar sheirbhísí cearta agus ba cheart an t-airgead seo a athdháileadh ar na seirbhísí sin gan mhoill.

Today is World Mental Health Day. It is a time for raising awareness of the mental health challenges our people face, reducing stigma and mobilising support for improved services for those in crisis. It is also a time to be honest about the Government's record and response to the real mental health crisis our country faces. The crisis is most acute when it comes to children and young people. On the watch of the Government, CAMHS has been brought to its knees. The facts speak for themselves. When the Tánaiste took office in 2020, there were just over 2,000 children waiting for a first-time appointment with CAMHS; today that number stands at nearly 4,000 children. The number of children forced to wait more than a year for their first appointment with CAMHS has more than doubled since the Tánaiste took office, on his watch. There are now 504 children waiting for their first appointment for more than year. When the Tánaiste entered Government, there were 72 CAMHS inpatient beds; today, there are 51. This is a runaway crisis. Vulnerable, at-risk children and young people are locked out of the urgent mental healthcare they urgently need. It is an emergency.

Incredibly, the centrepiece of the Government's mental health support for young people in this budget was to allocate €9 million for phone pouches. That is three times - three times - the additional money the Government provided for CAMHS, which was allocated just €2.9 million. What message does that send to the young people crying out for support and help? The case of one of those young people, Maggie, has been raised here a number of times. To remind the Tánaiste, Maggie is an eleven-year-old child. She is in desperate need of mental health support. She has endured cancer and suffers from depression, anxiety and self-injurious behaviour. Maggie is in severe distress. She does not leave the house apart from going to school. She was on an urgent list for more than a year before getting a CAMHS meeting. An assessment for intellectual disability followed but she was not accepted into that service because there is no specialist in her area. Maggie is in a mental health crisis. Her distraught mother has been begging the Government for help. The Tánaiste and Simon Harris gave commitments that they would look into Maggie's case. Her mother says neither the Tánaiste nor the Taoiseach have made contact. She received a generic response from the Minister of State, Deputy Butler, regarding a text service. The child has been waiting for more than two years for the services she needs. Does the Tánaiste really think €9 million for phone pouches will help Maggie or the thousands of other children in desperate need of these services?

Last night, Sinn Féin tabled a motion before the Dáil to reallocate that money to real mental health services. Despite the public outcry, one after another, Fianna Fáil, Fine Gael and Green Party TDs lined up to vote that proposal down. What in God's name does that say to these thousands of young people crying out for the services in relation to the Government's priorities? When will the Government stop digging in and accept this was the wrong call? Will the Tánaiste now tell those young people - 4,000 people waiting for a first appointment with CAMHS, more than 500 of them waiting for more than a year for their first appointment - and their families the Government will do the right thing and invest that money in mental health services that will help them and which they so desperately need?

Micheál Martin (Cork South Central, Fianna Fail)
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Is oth liom a rá gur uafásach ar fad an méid a dúirt an Teachta Dála. Tá sé ag iarraidh comparáid nó juxtaposition a dhéanamh idir an méid atá déanta i gcúrsaí oideachais agus an infheistíocht i gcúrsaí sláinte. Tá infheistíocht an-mhór déanta i gcúrsaí sláinte i rith na mblianta, go háirithe i sláinte leanaí, idir sláinte choirp agus sláinte aigne.

The Deputy's attempts to juxtapose a once-off €9 million expenditure on mobile phones with the broader and serious issue of mental health for children is despicable and disgraceful. It is a conflation and a deliberate attempt to propagandise, to try to grab something out of the budget and situate it in the context of mental health services for children.

Some €143 million was secured by the Minister of State, Deputy Butler, in this year's Estimate for mental health. In respect of mental health, 2% of the child population will need to access CAMHS. We have invested significantly in CAMHS over the past four years. We want to prevent children from developing anxiety and mental health challenges. The more action we take at the preventative stage, the better for the child and people more generally. I met Dr. Fauci when he was here. It is now acknowledged that the biggest public health challenge to children is social media and access online. The Deputy just ignores all of that for a cheap political stunt and headline. Can we not have a sensible discussion about mental health? I do not mind taking criticism but this is a superficial, shallow juxtaposition of a once-off expenditure to resource schools to once and for all deal with one of the most significant public health challenges to children by banning the use of mobile phones during the school day. It is one thing to say that but it is more important to resource that properly. Do not give me the bit about the old plastic bag which one of Sinn Féin's Deputies had - more cheap, superficial stuff. I have been in education. Principals always said to me not to come up with an initiative if you are not going to resources it properly. This is once-off expenditure. It will mean, definitively, that we put mobile phones out of use during the school day. That is in the best interests of the mental health of children.

In Northern Ireland, a similar programme was developed on a pilot basis and neither the Deputy, nor the Sinn Féin party and nor its finance and economy minister said anything because they probably accepted at the time that it was a legitimate initiative to try to protect children from the undoubted pressures of social media - the bullying, undermining of self-esteem and harassment from which serious mental health problems arise. Then, there is the educational achievement and development side where concentration is interrupted repeatedly, people's focus is interrupted and their learning capacity and journey are undermined and interrupted. That is the motivation.

In respect of CAMHS more generally, we want to reduce waiting lists. They are coming down but not by enough. Referrals are increasing significantly. There are 225,000 appointments for children and young people annually across 77 community teams. That is the scale of CAMHS today. CAMHS has increased and expanded significantly from 2011 to 2021 and 2021 to now. Referral rates to CAMHS are up 33%. We need to prevent children getting to the stage where they have to be referred to CAMHS.

Pearse Doherty (Donegal, Sinn Fein)
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The Tánaiste said it is despicable and disgraceful to conflate the €9 million the Government is wasting on mobile phone pouches with mental health. He should talk to his deputy leader.

In respect of CAMHS mroe generally, we want to reduce waiting lists. They are coming down but not enough. Referrals are increasing signficantly. Some 225,000 appointments for children and young people annually across 77 community teams - that is the scale of CAMHS today. CAMHS has increased significantly from 2011, to 2021 and from 2021 to now and expanded. Referral rates to CAMHS are up 33%. We need to stop preventing children getting to the stage where they ahve

It was Jack Chambers who wrapped this up in a mental health initiative. I put it to the Tánaiste that what is despicable and disgraceful is wasting €9 million when there are 3,641 children waiting on an appointment for child and adolescent mental health services, 504 of whom have been waiting for a year. Under the Tánaiste's watch, the number waiting has increased by 74%. The Government has closed down inpatient beds for those same individuals. That is what is despicable and disgraceful. Ban mobile phones in schools, but do not waste €9 million on a vanity project. Put that money into helping and making sure psychologists and other professionals are there to treat them. There is a crisis in mental health that the Government ignored. There are 18,000 children waiting for primary care psychology assessment.

The Tánaiste did not mention the case I raised at all. These are real crises and real children. These are people who are self-harming or have suicidal tendencies. The Government's brainwave is to come up with €9 million for phone pouches and the Tánaiste defends that to the hilt. Ban mobile phones in schools. Tell them to leave them in the locker. Use the €9 million to put services into CAMHS and help the children who are desperately begging the Tánaiste and Government to make sure there is a hand there when they reach out for help.

Micheál Martin (Cork South Central, Fianna Fail)
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When it comes to the mental health of a child, I am very reluctant to discuss an individual child's situation in regard to mental health publicly. That is a position I have, generally speaking. I do not think it is in the best interests of the child. Parents and others may disagree, but that is my view. These issues evolve. We need to help every child in difficulty. There are issues and I am not saying there are not, but to try to create the impression the €9 million is the be-all and end-all of provision for mental health is wrong. The issue of prevention is important. The Deputy has not acknowledged the impact of social media on young people and children. Talk to any parent in the country and they are extremely worried about the impact of mobile phones and social media on their health. This is not a vanity project but a genuine initiative to do the right thing. It is a once-off expense.

On inpatient beds, as of 1 October, the waiting list nationally to access CAMHS units was two. Of the available 51 operational inpatient beds for CAMHS, 37 were occupied, leaving 14 beds unoccupied. There has been a reduction in the number of young people admitted to adult acute units, from 84 in 2018 to 12 in 2023. That is good progress. The more we can keep out of acute-----

Pearse Doherty (Donegal, Sinn Fein)
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There are so many waiting on the list that cannot even see the professional to get into the bed.

Micheál Martin (Cork South Central, Fianna Fail)
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That is not true.

Mark Ward (Dublin Mid West, Sinn Fein)
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Seven hundred children were put in generic wards last year for mental health issues.