Report on Children's Mental Health Services: Statements

I welcome the Minister of State, Deputy Jim Daly. The committee Chairman, Senator Paul Coghlan, will lead off, followed by the committee rapporteur, Senator Joan Freeman. I call Deputy Coghlan.

I welcome the Minister of State, Deputy Jim Daly, to the House for this important debate and I acknowledge the work he has undertaken to bring about improvements in this challenging brief.

I also acknowledge his input into, and attendance at, the public hearings on this topic. The issue of children's mental health is of major concern to all Members. When the Seanad Public Consultation Committee, SPCC, was established in 2011, it was given the task of engaging directly with the public on matters of public policy. At the commencement of this current Seanad, when choosing its first topic for public consultation, the committee unanimously selected - on the proposal of Senator Joan Freeman - children's mental health services.

Given the importance each and every member of the committee afforded the issue, the committee issued a public invitation for written submissions and we were pleased with the phenomenal response we received. The committee sought submissions from all stakeholders, including the users of the service, those who provide the service, clinicians, doctors, psychiatrists and psychologists and policymakers. I sincerely thank all those who participated in the process. I was particularly grateful to the parents who presented to the committee during the public hearings. Listening to them relay their stories in their own words was a humbling experience for me and for other committee members. Each family's story made for compelling listening and strengthened our resolve that this public consultation should seek to ensure real and meaningful improvements in the provision of children's mental healthcare.

Our mental health can change as we go through life. I am sure all of us know somebody in our family, circle of friends or community affected by mental health issues. The effect this can have on family and friends cannot be overstated. Research indicates that mental health problems tend to begin when we are young and that by the age of 13, one in three people is likely to have experienced some type of mental distress. That is the time support and resources are vitally needed. Early intervention is essential when a child is in crisis, as delaying the provision of appropriate care can result in a child's condition worsening. The proper delivery of child and adolescent mental health services, CAMHS, is dependent on having the appropriate staff to deliver those services.

Mental illness should be treated no differently than physical illness. The evidence presented to the committee shows that if we invest in early intervention, we will make savings into the future as the number of crisis cases presenting will be reduced. Ireland should work towards a situation where supports are available nationally seven days a week and 24 hours a day. Otherwise, the gardaí, the voluntary sector and families have to step in when out-of-hours mental health services are unavailable. The committee believes the recommendations set out in its report are a valuable and timely input into the review of mental health services currently under way. We look forward to engaging further with the Minister of State, Deputy Jim Daly, who takes a strong interest in the issue. On behalf of the Seanad Public Consultation Committee, I sincerely thank Senator Joan Freeman for proposing this topic and for acting as rapporteur in the drafting of this report. We all acknowledge Senator Freeman's tremendous work in helping vulnerable people in our society.

I thank the Minister of State for attending. I thank the Chairman of the committee, Senator Paul Coghlan, who was extremely professional and guided our committee extremely well, and who readily agreed to accept the topic of mental health for the public consultation day. A number of mothers, in particular, gave heartbreaking evidence during that day. More than 60 submissions gave first-hand witness testimony of the disgraceful experiences that not only they, but their children, had to go through. We also heard from people who provide the service. They again talked about the harrowing conditions that some of them had to experience. There are extraordinarily kind, passionate and compassionate people within the children's services. Yet, here we were failing two massive groups of people - the people who needed the service and the people who provided the service.

It was a little upsetting when the report was published in October 2017, and the recommendations discussed, the Minister of State, Deputy Jim Daly, was invited to participate but he did not attend. As far as I am aware, outside of the interim report published by the Oireachtas Joint Committee on the Future of Mental Healthcare, this is the only report published during his tenure on a matter that falls under his remit, yet he was not there. A number of recommendations came about because of the report. I promise I will not go through them all because there are so many recommendations and issues to address that we would have to camp here. I will go through just a few of them. I refer to emergency out-of-hours care. The Department of Health submission noted that weekend mental health services are provided in only eight of the 17 mental health areas. Outline work is being undertaken to enhance a seven day a week mental healthcare service nationally. What has been done in this area so far?

Let us talk about the waiting lists. The latest data show that there are 2,818 children on the CAMHS waiting list, which is an increase of 3.6% per month. Promises about reducing that waiting list have been made again and again. What has happened in this regard? He referred to an initiative in 2015 that would decrease that waiting list. How stands that initiative at this point? I will address my favourite topic of all - the admission of children to adult units. There is a huge shortfall in child beds, but the HSE, in its submission, highlighted that it continues to address the admission of children into adult units. What has happened? It is interesting that one of the Minister of State's team told me face to face that children in adult psychiatric units are not only monitored daily but there is some form of communication daily that will prevent an increase in the time that child stays in that unit. What about the child who has spent 39 days in an adult psychiatric ward? He was let out of the room twice during those 39 days and he could hear men screaming around him. I refer also to a 15 year-old girl who had the same experience. What happened to the person in the Minister of State's team who said that it is always only temporary, it is only for a weekend or a couple of days? The information the Minister of State is receiving from his Department is inaccurate and he should question those who give it to him. I have not heard his statement but I respectfully say that it has probably been handed to him again. I wonder whether he will ever query the information that his Department is giving him because it is inaccurate.

I turn to something that is also close to my heart, which is staffing and recruitment. The HSE mental health division has said this is the biggest challenge in CAMHS. The attitude, again, from staff in this division is a shrugging of the shoulders. We are told, "Sorry, we cannot do anything about this; it is a problem that Europe is experiencing and there is nothing we can do". However, when we started to investigate why there is such a major issue with recruitment and retention, we gathered some interesting information. I again ask the Minister of State to challenge his Department on this. For example, before a clinical post can even be advertised, the job specification has to go through three committees.

The other element of the recruitment and retention of clinical staff is that there is a central panel interviewing a possibly suitable person for a position. The person being interviewed does not even see the place where he or she would be working. There is a series of questions surrounding this. The Minister of State knows I am not one bit cynical but if I were, I might suggest that these recruitment procedures are obstacles to delivering recruitment and are instead preventing recruitment or kicking the can down the road, something at which the HSE is so good. The system in place does not make sense. I ask the Minister of State to personally investigate that.

I will revert to the topic I keep bleating about. I am trying to get the Mental Health (Amendment) Bill 2016 through Committee Stage and I ask the Minister of State whether he will carry it through the Dáil when it passes through this House.