I propose to take Questions Nos. 150, 154 and 155 together.
The Government, despite severe financial pressures overall, has provided significant additional funding of €125m since 2012 to enable the HSE implement the long overdue modernisation of our mental health services, in line with A Vision for Change (AVFC).
Similar to elsewhere, Galway/Roscommon Mental Health Services are committed to full implementation of AVFC. The HSE appointed an Expert Group to review Community Mental Health services in the region. The Group’s Report was published in June 2014, and focussed on residential care settings and resources across both counties. The key goal was to make recommendations that would ensure service users maximise their full potential, and improve the quality of their lives. The report recommended that everyone who is in the residential services should have access to a rehabilitation team to ensure they reach their full potential and live their lives as independently as possible. The Area Management Team are proposing to put in place a project structure to oversee the implementation of the recommendations outlined in the report. In the interim Galway Roscommon Mental Health Services appointed a new Rehabilitation Consultant who took up her post last year. The Rehabilitation Consultant is leading out on the implementation of the recommendations contained within the review to ensure that each client is individually assessed and is receiving the most appropriate care for their needs.
The HSE in the Galway/Roscommon administrative area provides an inpatient and community Mental Health Service for a population of 314,000. They are at an advanced stage in the implementation of AVFC and have already moved into population sectors of 50,000, appointed team co-ordinators, and developed an over-arching Clinical Governance model.
The HSE has secured an additional 54 new staff posts for Galway/Roscommon since 2012, of which the bulk are now in place with remaining posts well advanced through recruitment. The new posts include additional Consultants in the areas of General Adult Community Mental Health Teams, Psychiatry of Later Life teams, and Rehabilitation and Recovery Teams. Allied staff includes Occupational Therapists, Community Mental Health Nurses, Social Workers and Psychologists.
In October 2014, a new Day Hospital was opened for Child and Adolescents across Galway and Roscommon. This initiative was completed with the help of clients of the service. The Day Hospital caters for adolescents aged 12-18 years of age with severe and/or complex mental health difficulties from the Galway/Roscommon CAMHS. This is a programme for those who require intensive, multidisciplinary treatment but do not require inpatient hospitalisation. Treatment will include intensive group, family and individual therapies but most importantly will allow the young person to remain at home with their family and remain within their community. Connections will be maintained with their school and other social supports.
Key to modernising services in line with current and future demand, and best international practice, is re-orientation from a hospital and bed-based focus to developing structures and processes required for enhanced community based provision.
It should be noted that the Galway/Roscommon Mental Health Service has a nursing complement of almost 400 whole time equivalent (WTEs). The service had a spend of €62.3m in 2013, €63.4m in 2014 and an allocation of €65m in 2015 before receiving its share of the 2015 development funding. Also, the service has mental health spending of around €190 per head of population which, when adjusted for deprivation indices, compares very favourably to the national average of €161 per head.
Following the closure of St. Brigid’s, approximately €3 million has been invested by the HSE in Ballinasloe to ensure that community based mental health services are delivered effectively. Its refurbishment was carried out to ensure reconfiguration of the building from acute to community based services, in line with A Vision for Change. The refurbishment was necessary also to meet relevant statutory building standards. The building is being used for Psychiatry of Later Life patients, Community Mental Health Teams, and Mental Health Intellectual Disability services and a range of other community mental health services.
With regard to the standard of care provided by the Inpatient Unit in University Hospital Galway an agreement was reached between the Health Service Executive (HSE) and the Psychiatric Nurses Association (PNA) on 3 June 2015, that a joint and sustained effort will be made to improve the quality of care for service users, their families and the staff who care for them. Central to this agreement is the opening of the high observation area and a revised staffing compliment of 64 WTEs which will further enhance patient care. During the implementation of this agreement there is a commitment to flexibility by all parties to mitigate any short term deficits or difficulties which arise. This is being aided by an additional 16 staff being recruited for the Community Home Based Intensive Treatment Team, as an alternative to admission to Galway University Hospital. The Roscommon area has developed a Home Based Intensive Treatment team, since February this year.
The Acute Unit in Galway continues to recruit additional Nursing Staff, including 2 Clinical Nurse Managers, 5 Registered Psychiatric nurses,1 Suicide Crisis Assessment Nurse, and progressing registration for 12 post graduate nurses. In addition, 6 Clinical Nurse Managers and 10 Staff Nurses are in the process of recruitment.
I understand that local HSE management has recently met with the Health and Safety Authority, and staff representatives, and that all concerns highlighted regarding Health and Safety are being addressed as constructively as possible. Any indication that Galway Mental Health Service is an unsafe service is unfounded, and any patient or staff member requiring assistance from the service is encouraged to do so.
