I thank the Chairman for the invitation to attend today's meeting. Members will have received a separate briefing document which sets out details on mental health finances and governance.
As outlined in the 2017 HSE mental health division operational plan, the mental health division remains focused on providing and developing mental health services across the country. The overall HSE budget has increased year on year since 2014. Currently, the mental health budget accounts for 6.2% of the overall HSE budget. Mental health funding is allocated to the HSE in a context where this is agreed on an annual basis through the national service planning process. This, in turn, is agreed and approved by the Department of Health and the Minister of State with responsibility for mental health.
The mental health division acknowledges that a broad range of services support the mental health and well-being of the population. Specialist mental health services are provided through child and adolescent mental health services, CAMHS, general adult mental health teams, psychiatry of old age teams and the national forensic mental health service. Each of these multidisciplinary services treats moderate to severe mental health disorders. However, specialist mental health teams are only one part of a larger health system that addresses the mental health and well-being of the population. This whole system includes services at primary, secondary and tertiary care levels. Specialist mental health services sit within the secondary and tertiary care levels. Community teams are supported by day hospitals and inpatient units, where necessary. Examples of primary care services include general practitioners, clinical psychologists, speech and language therapists, etc.
The HSE also provides counselling in primary care, CIPC, and the national counselling service, NCS, as well as funding a number of agencies to provide psychological supports to the population. In addition, the National Office for Suicide Prevention is an integral part of the HSE mental health division.
The mental health division is committed to improving specialist mental health services and working with HSE primary and social care and our community partners to develop a comprehensive range of services to support the mental health of the population. Actions in this regard include increased recovery orientation of all mental health services; a focus on quality and service user safety; developing a range of service improvement initiatives focused on meeting the needs of our most vulnerable, for example, mental health in intellectual disability, homeless populations and dual addiction and mental health needs; and promoting positive mental health via an integrated mass media campaign, Little Things, which had 1.5 million page views in 2016 and is now being developed for priority groups.
The mental health division has a clear focus on best practice and improving outcomes, as set out in our clinical programmes. In addition, we are focused on youth mental health where, among other initiatives, €5 million has been allocated to primary care to recruit 120 assistant psychologists to develop early intervention services for those aged under 18 years.
Staff recruitment in mental health continues to be a significant challenge, resulting in the underdevelopment of mental health teams in certain areas which then impacts on access, targets and waiting times. The lack of availability of suitably qualified staff also contributes to inadequate out-of-hours services.
Regionally, the nine community health organisations, CHOs, have responsibility for the delivery of community health care services in their areas of responsibility. While the chief officer of the CHO has overall responsibility, the head of service for mental health, in conjunction with the executive clinical director, is responsible for the delivery of mental health services in the CHOs. The forensic mental health service operates on a national basis. Through monthly performance engagements with the nine CHOs, the mental health division has a clear line of sight on service delivery in each area.
The mental health division remains committed to the development of high quality, integrated mental health services in a spirit of partnership with service users, families and other key stakeholders, as part of a whole system approach to the mental health and well-being of the population. The recruitment of a sufficient number of skilled staff and the development of equitable access to services continue to be key priorities for the mental health division.