'Something has to change' in Ireland’s 'inadequate' youth mental health system

Almost 15,000 college students were seen on campus by Psychological Counsellors in Higher Education in Ireland (PCHEI) in the academic year 2020/21 out of a student body of some 245,000 people.

Ireland’s youth mental health system is increasingly under pressure — over-stretched, under-resourced, and, in large parts, inadequate.

Dr Joseph Duffy, CEO of Jigsaw, the National Centre for Youth Mental Health told the Oireachtas Sub-Committee on Mental Health that demand continues to outstrip the system's ability to cope.

“Funding is insufficient. Integrated, joined-up thinking remains an aspiration in many areas. And yet, behind a discourse increasingly dominated by ‘demand', ‘systems’ and ‘integration’, are young people struggling to cope and parents left to shoulder the pain,” Dr Duffy said. “Something has to change.” 

A significant increase in anxiety and depression in young people in Ireland was noted over the last decade in the My World Survey 2, which was published by Jigsaw in association with the School of Psychology, UCD in 2019.

“While covid-19 has contributed significantly to a deterioration in young people’s mental health, long before covid, the indicators were not good," Dr Duffy said.

In 2022, 8,405 young people sought support from Jigsaw’s community-based services. This was the organisation’s second-highest number of referrals in a single year. Last year, it offered 36,360 appointments to young people across its community-based services. This was the highest number of appointments ever offered in a single year.

The most common concerns among young people attending Jigsaw’s brief intervention services in 2022 were anxiety (68%), low mood (40%) and sleep changes (34%). “Many of our services continue to experience unmanageable demand, resulting in the time between first contact and first appointment, in several Jigsaw services, remaining too long," Dr Duffy said. 

Recommendations

Jigsaw made five key recommendations to improve youth mental health services. “A new model of funding for youth mental services and supports, especially at the primary level, is essential as a matter of urgency now, more than ever,” Dr Duffy said.

“It is simply not good enough that just over 5% of the State’s total health budget is ring-fenced for mental health in Ireland. We must, at a minimum, increase mental health funding in line with Sláintecare recommendations of 10%.” 

Secondly, community-based, primary care services and supports that are preventive and early interventionist in approach must be prioritised at a policy and funding level to prevent mental ill-health rather than just intervening once they’ve become entrenched or reached crisis level, he said.

Thirdly, young people must be listened to and have the right to be involved in decisions on their care that affect them.

Fourthly, a workforce strategy must be developed because, at present, “we simply do not have enough mental health professionals to deliver vital care”. 

Better integration of services is also needed, Dr Duffy said.

College pressures

Almost 15,000 college students were seen on campus by Psychological Counsellors in Higher Education in Ireland (PCHEI) in the academic year 2020/21 out of a student body of some 245,000 people, Union of Students of Ireland (USI) Mental Health Program Manager Sarah Hughes said. 

Housing must now be considered as a factor of mental illness and housing provision must be considered as part of mental health treatment, Ms Hughes said. Lack of access to housing is forcing students to commute up to six hours a day, with impacts on sleep deprivation and mental health, she said.

Loneliness was a major mental health problem impacting the student body when a study was conducted in 2019, before the pandemic and the isolation it enforced began.

Although stigma around mental health issues has lessened, there is still a large problem with self-stigma, she said – although students may encourage their friends to talk or seek help, they do not want to admit suffering with mental health problems themselves.

A drive to perfectionism on college campuses — where people want First Class honours rather than to just pass exams and to get the very best work experience — all add to student pressure, she said. International research showed that 35% of students screened positive for at least one of the common lifetime disorders, she said.