Anti-depressants: A Step in the Right Direction, But a Long Way to GoIn light of the HSE’s recent boost to their Little Things campaign, Katie O’ Dea examines the shortcomings in mental health resources in Ireland.Irish society has come a long way on the issue of mental health. What was once a taboo subject is now beginning to be unfolded and discussed, albeit with no shortage of stigma attached. The HSE’s ‘Little Things’ campaign is one step in promoting positive mental health and opening up a discourse in Irish society. The campaign emphasises the little things we can do to improve our mental health, such as keeping active and talking about our problems. An aspect almost as important as the message itself is what is behind it, a state-funded investment into people’s mental health. This is, in effect, a public acknowledgement of the seriousness of the issue by the HSE and, by extension, the government.Although many might argue that it is too little too late, or simply not enough, particularly in light of recent budget cuts to mental health, it sends an important message to all Irish people. To those suffering from or affected by depression, anxiety, or other mental health issues, it says that their government acknowledges them and has not abandoned them. To those who remain unaware as to the extent of depression as an illness, it too sends a strong message; this government takes mental health seriously, and so should you. Whether it is doing enough to combat stigma is another debate, but the message that such a high-profile and well-funded campaign sends is an important one.
Where are the resources and services to back up the expensive television and radio campaign advertisements and lengthy public discussions?The fact that depression and poor mental health is a major issue in Ireland is not news. Aware, a charity which supports people with depression, estimates that as many as 450,000 are affected by depression in Ireland at any time. According to the WHO (World Health Organisation), more than 300 million people globally suffer from depression and it is the leading cause of disability worldwide. Between 2011 and 2016, an average of 467.5 people committed suicide in Ireland each year.Ireland was first introduced to antidepressants in 1987 with the USA-imported ‘sunshine drug,’ Prozac, followed by second and third generation antidepressants. There is growing concern, however, that antidepressants are being overprescribed. Doctors, under pressure to do something for their patients, prescribe antidepressants without their patients necessarily being able to avail of counselling services. For individuals who feel they need more than just antidepressants, they are stuck.
There is strong evidence to suggest that an important aspect in tackling depression is taking care of an individual’s psychological needsDepression is understood medically and scientifically as a chemical imbalance in the brain, low serotonin levels, and it was on this basis that medication has been designed to treat it. However, there is strong evidence to suggest that an important aspect in tackling depression is taking care of an individual’s psychological needs, and this highlights the large problem: where do people go when they need counselling help? Services such as the Samaritans are not counselling outlets, and cannot such facilities. Where are the services to back up the expensive television and radio campaign advertisements encouraging people to seek help? This is not wishing to take away from the positive work that these campaigns have achieved, but it feels like someone forgot to ask the question of what will happen to these people once they feel empowered to take action and find scarce resources to do so.This is a clear reflection of the shambolic state of our healthcare system. In July of last year, it emerged that 2,400 children and adolescents were on waiting lists for mental health services, 218 of them for longer than a year. We are frequently told that medical staff are overworked and that there is a severe lack of resources in the HSE. While the stigma surrounding mental health has undoubtedly been eroded in recent years and will likely continue to be eroded in years to come, the resources available to deal with mental health issues are wholly inadequate. UCD counselling services are quite literally outsourcing their services to private providers to keep up with the demand of students. In November 2017, the University Observer reported that there were 194 students on a waiting list for the counselling service and that “the waiting list is the highest it’s ever been for a number of years.” When people are ready to talk, someone needs to be there to listen.If you need someone to talk to you can freephone Niteline at 1800 793793 between 9pm and 2:30am, and Samaritans at 116 123 during the day. You can also check out niteline.ie, pieta.ie, and samaritans.org.