Ireland’s mental health system is struggling under a level of need it can no longer meet. Despite years of public discussion about the importance of mental health, services remain underfunded, overstretched and, in many cases, unsafe. This ongoing underinvestment shapes every aspect of care and has serious consequences for people across the country.
Mental health receives less than six per cent of Ireland’s total health budget. This falls far short of what is required for a modern and functioning system. The consequences are visible everywhere: long assessment waiting lists, inconsistent provision, overwhelmed crisis pathways, overcrowded emergency departments and the daily experiences of people who simply cannot access the help they need.
Research carried out by Maynooth University, the National College of Ireland and Trinity College Dublin shows that forty‑two per cent of Irish adults meet the criteria for at least one mental health disorder. In real terms, nearly half of the population is living with significant psychological difficulty. Yet only a small proportion of those who seek counselling or psychological support ever receive it. Many people wait months or years for help and, while they wait, are prescribed psychotropic medication because it is the only intervention available immediately.
These drugs have become the default response. In 2024, almost half a million antidepressant prescriptions were issued to adults, with prescribing for children and adolescents also rising. This widespread use reflects a lack of accessible alternatives rather than a well‑resourced therapeutic system. In many cases, psychotropic drugs are prescribed not because they are the most suitable intervention, but because no other support exists.
This raises wider concerns about whether people are being treated effectively, or whether their symptoms are simply being managed without proper investigation. Many individuals receive medication without full screening for physical conditions that can mimic or worsen mental health problems. Thyroid disorders, hormonal changes, vitamin deficiencies, chronic pain, sleep difficulties and neurological conditions are often overlooked. A responsible mental health system would ensure proper physical screening, routine blood tests and a full review of a person’s overall physical health. Without this, the link between physical illness and mental health is too easily ignored. More routine physical examinations would improve diagnostic accuracy and reduce unnecessary reliance on psychotropic drugs when underlying medical causes are present.
The weaknesses in Ireland’s system become most visible when a person reaches crisis point. Adults who present with suicidal thoughts are frequently told to go to A&E because dedicated mental health crisis services do not exist in most regions. A&E departments are bright, noisy and chaotic — appropriate for physical emergencies, but entirely unsuitable for people in acute psychological distress. Yet this practice continues because there is no alternative. Reports have described cases in which adults presenting with clear suicidal intent were discharged without ever being assessed by a mental health professional. Some later died by suicide. These cases illustrate a system that reacts too late and too briefly, and that routinely leaves people at risk.
Children and adolescents face similar failings. CAMHS has been heavily criticised for long delays, poor capacity and inconsistent support. Thousands of children remain on waiting lists and many wait over a year to be assessed; in some areas, the delays are far longer. Some families struggle even to secure a place on a waiting list. Children who present with self‑harm or suicidal thoughts have, in some cases, been sent home without a full assessment or safety plan.
Demand for neurodevelopmental assessments has risen sharply. Referrals for autism and ADHD have more than doubled, and in some regions have increased by three hundred per cent. Around one in twenty school‑aged children in Ireland now has an autism diagnosis. Dual diagnoses of ASD and ADHD have also become more common. Yet post‑diagnostic support is inconsistent, limited and often unavailable.
Concerns continue to grow about psychiatric prescribing in young people. Several cases of severe overprescribing of psychotropic drugs have been reported, with harmful effects on children and enormous distress for their families. These incidents highlight the urgent need for greater oversight, improved training and stronger accountability within child and adolescent psychiatry.
Adults seeking ADHD assessments face similar obstacles. Many have spent years struggling without understanding why daily life felt so difficult. Increased awareness has led to a surge in referrals, but assessment teams cannot meet demand. Waiting lists remain long, and support after diagnosis is often absent. Many adults receive a diagnosis and medication, yet receive no meaningful guidance or follow‑up.
Some harmful psychiatric practices from the past have not disappeared entirely. Psychiatry has a long and troubling history marked by interventions that caused trauma. Many argue that the profession must acknowledge these harms and commit to long‑overdue reform grounded in human rights. The continued use of electroconvulsive therapy is one example. Its use in Ireland has increased by five per cent each year, and 265 patients received ECT in 2024. Many believe that ECT has no place in a humane and modern mental health system.
Across Ireland, there are clinicians who work tirelessly to support those in distress. The failures of the system are not a reflection of their dedication. They are working in structures that force them into reactive practice rather than preventative care. Too many people become trapped in a cycle of crisis admissions, short periods of stabilisation, medication changes and rapid discharge without the psychological support required for long‑term recovery.
The current system is failing. It is not protecting the people who depend on it. Ireland’s mental health services need real reform, real investment, real leadership and real accountability. People should not wait years for therapy or assessment. Children must not remain on waiting lists that outlast their childhoods. Families should never be forced to battle a system that was meant to fight for them. This country needs a mental health system built on transparency, respect and evidence‑based care — one rooted in dignity and human rights, where psychiatric practice is fully accountable under the law.
