Dáil Éireann Debate, Tuesday - 4 March 2014
493. Deputy Colm Keaveney asked the Minister for Health his response to the latest Children's Rights Alliance report card, which for a second year running downgrades the Government's performance on mental health and is now awarding an E grade; and if he will make a statement on the matter. [10967/14]
View answerThe Government has prioritised reform of all aspects of our mental health services in line with A Vision for Change, including additional and improved quality care for children in both residential and community based settings. Total HSE Mental Health funding in 2014 is significant at around €766m. In this context,additional funding of €90 million, and around 1,100 new posts, has been provided over the last three Budgets. This has been primarily directed to strengthen Community Mental Health Teams for adults and children; specialist community mental health services for older people with a mental illness, improving services for those with an intellectual disability and mental illness, and enhancing Forensic Mental Health services.
Key to developing Child and Adolescent Mental Health Services (CAMHS), as per A Vision for Change, is the establishment of 99 multi-disciplinary CAMHS Teams providing acute secondary mental health care in the community, including hospital liaison and Day Hospital services. In 2008, there were 54 CAMHS Teams. There are now 61 Teams in place. The additional €90m provided for mental health over 2012–14 is being used, in part, to expand and enhance the skill mix of CAMHS Teams. Around 230 new posts were allocated to CAMHS Teams over 2012-13, and recruitment of these is well advanced. More CAMHS posts are planned for later this year. Just over 14,000 referrals were received by the Child & Adolescent Mental Health Teams in 2013. This represents nearly 1,000, or 8% more, than projected in the HSE National Service Plan 2013, while the target of 70% of referrals being seen within 3 months was maintained.
A Vision for Change recommends the provision of 80 Child and Adolescent psychiatric in-patient beds nationally. In 2008, there were 16 such beds and at present there are 51 beds operational country-wide, with more planned. Capacity will be enhanced also, with the completion of the CAMHS Forensic Unit as part of capital developments now underway for the National Forensic Mental Health Service, and the National Children’s Hospital. In addition, improved community based services, coupled with increasing bed capacity, are all aimed at discontinuing the practice of placing children and adolescents in adult acute in-patient units, except in exceptional circumstances. Admissions of children to adult units have decreased by almost 60% from 2008, when there were 247 reported, to a provisional figure of 106 in 2012.
The review of the Mental Health Act 2001, already well progressed, is a key step in providing a revised and more modern mental health legislation in this country. The Programme for Government contains a commitment to review the Act, informed by human rights standards and consultation with service users, carers and other stakeholders.
The review has been delayed due to a number of factors, including the wishes of members of the Expert Group to first see details of the Assisted Decision Making (Capacity) legislation, which was published in June 2013. Due to the high level of inter-connectivity between both sets of legislation, members of the Expert Group reviewing the Mental Health Act felt it would be necessary that the Capacity Bill should be finalised before they completed their own review.
Work is continuing on the completion of the report of the Expert Group, and members are carefully deliberating, re-examining and refining their recommendations on key central issues such as consent to treatment, capacity, criteria for detention, and treatment of children under the Act. It is expected that the final report will be completed in the near future, after which its recommendations will be considered at Ministerial level.
I have noted the contents of the recent report by the Children's Rights Alliance on Mental Health services. As I have indicated on several occasions in the past, despite the real and significant improvements that have taken place on implementing A Vision for Change and modernising mental health services across the country over the last three years, historic deficiencies remain to be addressed. The aim is to strive for equity in providing high quality services, while balancing residential and community-based provision. This approach has already been proven in many areas at local level. The Government will retain its commitment to mental health, and focus on up-grading all aspects of mental health care, in line with evolving service demands and resources available overall for the Health sector, for 2014 and beyond.
