Dear Minister Varadkar,
I invite you, for just a moment, to imagine a beating heart. The sound it makes. The steady, rhythmic thump-thump of a heart pumping to keep the body it exists in alive. Imagine that sound multiplied by 7,000. Let the thump-thump fill your ears. Seven thousand people’s hearts, beating in sync. It’s almost a pulsating roar.
Imagine the silence as they all stop. Imagine the emptiness ringing in your ears. Seven thousand heartbeats, suddenly ceasing to exist.
Since the year 2000, more than seven thousand people in Ireland have died by suicide.
It may come as no surprise to you, Minister, that we are more than slightly angered by the upcoming cuts to the mental health budget. Public healthcare may be a stranger to you, something availed of by poor people or those unable to get insurance, but it is not a stranger to me. It is not a stranger to an immeasurable amount of friends; some with medical cards, some without, and some without the means to pay for private mental healthcare but who do not, ultimately, qualify for a medical card. I understand that funds are to ‘return to the mental health budget in 2017’ but at what cost? And I do not mean financial cost. How many more lives are to be taken this year due to this diversion of €12m?
It should also come as no surprise to you that there are positions going unfilled in public mental health services. At the beginning of last summer I was referred to my local public service, only to be told that there was a 7 month waiting list to see a psychologist. One had gone on maternity leave, while the other had left with no replacement offered. Notwithstanding that there were only two psychologists to cover the therapy needs of hundreds of people, the fact that these essential facets of mental healthcare were not replaced immediately says a lot about the way this money is allocated. I was lucky last year. I was in my final year of family insurance cover and eventually got the help I needed from the private sector. Had I waited any longer, I would probably be dead. This is not an exaggeration. This is another fact. I was lucky. Thousands of others are not.[pullquote]I understand that funds are to ‘return to the mental health budget in 2017’ but at what cost? And I do not mean financial cost. How many more lives are to be taken this year due to this diversion of €12m?[/pullquote]
The €12m you are allowing to be diverted had been set aside to provide 1,550 jobs in the mental healthcare sector. It is my understanding that these probably weren’t filled because you were seeking cheap labour through JobsBridge schemes. You wanted qualified psychologists to earn €50 a week to do what is arguably one of the hardest jobs in the world. Is it any wonder these jobs went unfilled?
‘Newly qualified’ psychologists are still qualified. They have gone through at least four years of an undergraduate degree, four years of a Postgraduate and Masters degree, have achieved PSI (or equivalent) accreditation – which as Minister for Health I’m sure you understand involves 450 hours of unpaid counselling. That 450 hours may amount to up to two years of working for free. And of course there are supervision sessions costing a minimum of €50 a session, which must be undertaken after every 5 hours of accreditation work. €0 times 450 is €0, but those hours of supervision cost at least €4,500 euro. Add that to the insurance that is legally required to practice psychology, and you’re looking at the guts of more than €50,000 just to get qualified.
This isn’t even including continued professional development (CPD) and the cost of living. But I’m sure as Minister for Health you know all of this already, and that’s why you’re able to justify paying people €50 a week. In just 1,000 weeks your ‘student psychologist’ will have earned back the €50,000 they spent in order to be able to help people. I imagine €50,000 is nothing to you. [pullquote]Add that to the insurance that is legally required to practice psychology, and you’re looking at the guts of more than €50,000 just to get qualified.[/pullquote]
Those 7,000 suicides since the year 2000 are a conservative figure and don’t include those who have already died this year. And they definitely do not include deaths by drug overdose or alcohol. The years 2004-2010 saw 3,972 deaths due to overdoses – a large portion of which you can imagine were probably deliberate.
After alcohol, the second biggest cause of death by poisoning was through Benzodiazepines – which, I’m sure you are aware, cover commonly prescribed drugs such as Xanax and Valium. These are the drugs commonly thrown at anxiety patients by GPs because there’s nowhere else for them to go, and nothing else for them to do other than self medicate. Sure, they help some people, but Xanax typically has a two-week period where they work at the dose they’re prescribed, and are renowned for being habit-forming. It’s no wonder so many people died. I’m sure you know all of this already.
I think we were all touched during the Marriage Equality campaign that you used your own, lived experience in order to convey the importance of a Yes vote. I do not mean this facetiously – it was necessary to show people that the referendum was affecting the lives of real people in real ways. Now, we are imploring you with real experiences to rethink the budget plan. That €12m, which may be a drop in the Budget Ocean to you Minister, equals 1,550 jobs and the difference between life and death.[pullquote]The second biggest cause of death by poisoning was through prescribed drugs such as Xanax and Valium – the drugs commonly thrown at anxiety patients by GPs because there’s nowhere else for them to go, and nothing else for them to do other than self medicate.[/pullquote]
It could be the difference between actually getting to experience a life worth living instead of suffering every single day. I am asking you this as someone on the long waiting list for therapy with my local services, as I am currently deemed to be ‘too well’ to avail of these services at present. At this stage, my self-esteem and anxiety issues are a luxury to get treated. Compared to seven months ago, I’m living life relatively happily. But that waiting list should not be the case for anyone.
I have one friend who has been turned away from local services for not ‘fully’ meeting criteria for an eating disorder that has plagued her for years. I have multiple friends currently being bandied around different psychiatrists and psychologists and being given different drugs because the public sector cannot presently cope with the staff shortage. I have another friend who is struggling to pay a therapist every couple of weeks but will continue to try, because she cannot mentally afford to wait on a public list for months. I have friends with Borderline Personality Disorder, Bipolar Disorder, OCD, Major Depressive Disorder, anxiety and depression issues, Anorexia, Binge Eating Disorder – you name it and I probably know someone suffering with it who is unable to get help from a system that failed to fill 1,550 positions because you weren’t willing to pay a living wage.
Therapy and psychiatry are not easy jobs. Struggling to eat and pay bills only adds to the danger of burnout that therapists are constantly at risk of. But as Minister for Health, I’m sure you know what you’re doing. Those 7,000 stilled hearts will be joined at the ranks by hundreds more people this year who will die by suicide. Those ‘talk to someone’ campaigns are nothing more than shouting into a deep, dark void where there is no one to answer back.[pullquote]That €12m, which may be a drop in the Budget Ocean to you Minister, equals 1,550 jobs and the difference between life and death.[/pullquote]
I am lucky that I have friends who understand me and what I’ve been through – but it’s only through the misfortune of struggling themselves with a two-tier system that suggests poor people don’t deserve to live and rich people can get the thousands of euro worth of support simply because they can afford to pay for it.
Pieta House are excellent, and they are one of the reasons that I am still alive today, but they cannot pick up the slack in the wake of the failings of the Irish government. Nor can any other charity organisation. You, as Minister for Health, are now going to be responsible for the increase in suicides we are likely to see this year. These days, asking for help is easier than getting it. Many of those that do ask for it are going to resort to long term solutions to what should be short term problems.
Maybe if that €12m was put into hiring people through something that wasn’t ultimately a cheap-labour scam, those positions would be filled within months. I’d rather 1,550 new psychologists and mental health professionals who still need to check in with a consultant regularly, than nobody at all.[pullquote]Those ‘talk to someone’ campaigns are nothing more than shouting into a deep, dark void where there is no one to answer back.[/pullquote]
Not only that, I want answers. Not a stock answer, or to be fobbed off, but a real answer on behalf of every single person that is struggling with our deplorable two-tier system. On behalf of everyone who has lost a loved one to suicide because they had no help in fighting their demons I am asking you, Minister, to explain to me and everyone in this country what it is you think you are doing. I ask you to justify the loss to a sector already built on a skeleton structure. I ask you to justify it to those that have lost someone, and to those that are considering leaving. I ask you to justify it to those who struggle to get out of bed every day as the hardships of life do nothing to console the battle with demons you can’t see.
As Minister for Health, the well-being of the Irish people should be your top priority. With 90 year old women languishing on trolleys in hospital corridors, and my generation struggling to see a point to living, I am not going to sit in silence. The number of people who signed this petition so far probably mirrors the amount of lives lost in the past 16 years. They want answers. We all do.