Dáil Éireann Debate, Tuesday - 24 June 2014
537. Deputy Simon Harris asked the Minister for Health the reason dialectical behaviour therapy is not provided by the Irish health services for adolescents despite the fact that this is a recommended treatment for borderline personality disorder and the fact that this treatment is available in other countries, including the UK; and if he will make a statement on the matter. [26657/14]
View answerThe core aim of the HSE National Office for Suicide Prevention is to oversee the implementation, monitoring and evaluation of Reach Out, the National Strategy for Action on Suicide Prevention 2005 – 2014. Action Areas 12 and 13 in Reach Out which specifically relate to Deliberate Self-Harm and Mental Health Services aim to:
- Develop and resource an effective response in the health services for people who present to services having engaged in deliberate self-harm and design ways to reach out to those who self-harm, but are reluctant to access traditional services and supports.
- Improve mental health service provision, especially in the areas of community mental health, pre-discharge assessment from in-patient services, and follow-up support.
Dialectical Behaviour Therapy (DBT) helps reduce self-harm and self-destructive behaviours, using a combination of group skills training, individual therapy and phone coaching. DBT is delivered by a team of mental health professionals including psychiatrists, psychologists, social workers, occupational therapists, and nurses. It comprises individual therapy sessions for each participant, group skills training sessions delivered by two clinicians, crisis phone support and consultation meetings for clinicians each week.
Foundation and Intensive DBT training has been made available to all Integrated Service Areas through HSE National Office for Suicide Prevention funding in 2013/2014. Decisions on how, and if, DBT is provided are a matter for local HSE management. DBT training is not mandatory, and is very resource-intensive both in terms of preparing for, and committing to, training and subsequent service delivery. As such, it may not be suitable to all areas, and is only one of a broad range of service interventions.
By the end of 2013, 19 Community Mental Health Teams were trained in DBT. This includes 5 Child and Adolescent Mental Health Service (CAMHS) teams based in Donegal, Sligo, Cork (North Cork and North Lee area), and Linn Dara in Dublin. The HSE indicate that three more CAMHS teams will begin training in September 2014 - Cork South Lee, Galway and the Lucena clinic. All area teams were offered the opportunity to apply for this initiative, and all CAMHS teams that applied were accepted.
In 2014, the Department of Health and the HSE have committed to developing a new strategic framework for suicide prevention, building on the comprehensive work delivered under Reach Out. One of the core areas of practice for review and development is DBT. The framework, which is expected to be completed by the end of the year, will provide for improved coordination and integration of services to ensure that pathways of care for persons at risk of suicide or in suicidal crisis can be accessible, acceptable and available.
