Thursday, 11 July 2019

Questions (643)

James Browne


643. Deputy James Browne asked the Minister for Health the status of each of the recommendations of the national youth mental health task force; and if he will make a statement on the matter. [31054/19]

View answer

Written answers (Question to Health)

The information requested is set out in the table.



Consultation and Advocacy

1.1 - Pathfinder should take a lead in formalising mechanisms to ensure that the voices of young people are fully considered in the development and implementation of legislation, policy and services for youth. The Pathfinder team should develop mandatory protocols which will work to safeguard young people against potential changes in policy that could negatively impact on youth mental health

1.2 - Policies involving young people should be published in simple, straightforward language that young people can understand

1.3 - A process of youth consultation should be carried out when designing mental health and other support services and facilities for young people

1.4 - An independent National Youth Mental Health Advocacy and Information Service should be established. Consultation should be informed by children and young people and should include the HSE, which is developing a tender for a Child and Adolescent Mental Health Services (CAMHS) youth advocacy pilot.

Work has been advanced to establish a Youth Mental Health Pathfinder Team. There has been considerable communication and work performed in addressing outstanding governance, staffing and funding issues. Activities are not yet complete in fully developing and rolling out a Pathfinder unit, but work is on-going.

At the end of May Minister Daly had a constructive meeting with Minister Donohoe and his officials. They are very supportive of the proposal, subject to resolving the outstanding matters. I hope to make substantial progress on the matter in the coming months.

Policies involving young people are issued to the young people’s forum in DCYA for review prior to publication.

This is to be a part of the Pathfinder project once agreed.

A pilot adult inpatient advocacy service is being rolled out in St Patrick’s Hospital and the HSE will use the learning’s from this pilot to determine how best to establish a young advocacy service. Work has been completed to determine the merits of establishing the advocacy service as (i)a separate structure independent of the HSE, (ii) a structure within the Child Ombudsman or indeed (iii) a new NGO agency. A draft business plan has been drafted and data from the HSE pilot will provide a template for how best to proceed in an Irish context.

Awareness and Training

2.1 - A series of sustained and evidence based awareness campaigns should be developed, specifically targeted at children and young people, to improve mental health, emotional literacy, build resilience, and aid the development of coping mechanisms

2.2 - Sustained, quality-assured and evidenced-based training programmes should be funded to provide support to individuals in the public, voluntary and community sectors who have contact with young people so that those trained might be in a better position to promote positive mental health

The HSE have been examining International awareness initiatives that might be applicable in this jurisdiction.

Little Things Mental Health Campaign for 2nd level students:

HSE Mental Health has been running the Little Things Campaign since 2014 to promote protection and improvement of mental health for the whole population. The campaign focuses on 9 protective factors that can help build resilience and improve mental health and wellbeing. There were 87,000 followers of Little things on social media in 2017. There were 3.2m visits to between 2014 and 2017.

In 2017 work commenced on adapting the Little Things Campaign to tailor the messaging and make it more relevant to young people, who are also listed within Connecting for Life as a priority group. Using research conducted by online youth mental health service,, which highlighted key areas of stress for young people the HSE identified 6 issues to include in the new campaign; Exams, Sleep, Digital devices and Bottling up your feelings, Relationships and Image.

Imagery and messaging has been developed for 4 of the key areas and will be made available as poser packs to schools, youth and sports clubs around the country. The messaging has been developed to inform young people about the things they can do to reduce stress and anxiety.

The campaign will be promoted on Radio, Social Media and through Digital ads targeting young people through relevant channels. We will be signposting to for more information on the topics and will also promote the Childline text and phone option for any young person that might need immediate support. Content on all 6 issues, developed in partnership with SpunOut will also be hosted on

HSE/USI ReCharge Mental Health Campaign for 3rd Level Students:

HSE Mental Health is also funding a new Mental Health awareness campaign with USI to target third level education students. This campaign is due to be launched on the 12th of November in University College Cork. The HSE funding has been used to create a new campaign logo and tagline, three new posters to address the effects that Alcohol, Sleep and Exams can have on mental health and ways to help manage any stress related to those issues. A new leaflet with more information on protective factors and ways to seek help will also be produced as well as content on both and USI is the national representative body for 374,000 students in 3rd level education and also receive funding from the HSE to provide training courses in SafeTALK, ASIST

Mental Health First Aid

Mental Health First Aid training for young people

HSE Mental Health funds Mental Health First Aid to deliver courses to various target groups. Participants learn the signs and symptoms of mental health problems and what sort of help has been shown by research to be effective. The training has been shown to improve attitudes towards people with mental health difficulties, reduce stigma, improve knowledge, and improve people’s confidence in providing help and likelihood to advise people to seek professional help. Over 2000 individuals and professionals have been trained in 2018 and the training will continue in 2019.

Perinatal Training

The HSEs Specialist Perinatal Mental Health Services Model of Care was launched on 30.11.2017. Its implementation is now being directed and overseen by the Clinical Lead and Programme Manager. Specialist Perinatal Mental Health Teams are being recruited for the maternity hospital/service hub in each of the six Hospital Groups. Two of the teams are now operational. As part of this implementation a mental health midwife is also being recruited for each of the maternity hospitals/units with two for the four larger services, those with over 8,000 deliveries per year. Apart from the perinatal psychiatrists heading up each specialist hub team who are directly trained in the speciality, all other staff will require training in perinatal mental health. The National Implementation and Oversight Group is in the process of drafting a training document and in the meantime all newly recruited staff are being provided with the appropriate induction and training.

National Telephone Line

3.1 - The Taskforce recommends increased investment in age-appropriate, scalable digital youth mental health supports in conjunction with existing providers to ensure all young people ages 0-25 have access to an active listening service and dynamic signposting tool.

HSE Mental Health has sought to advance the establishment and operation of a single and stand-alone National Mental Health Service Telephone Contact Facility to effectively manage mental health service related queries emerging from the community. This service will operate on a 24/7 basis and will encompass

(i) the provision of information about, and direction of callers to, the most appropriate national and local pathway(s) to care specific to the query raised, and (ii) where possible the direct transfer of callers to the most appropriate existing helpline partners and/or services as required.

Resource allocation has been agreed between HSE Mental Health and the National Ambulance Service (NAS) have recruited new NAS call takers. Training of call takers has commenced and will last for 14 weeks. An Expression of Interest is being sought for a suitably qualified mental health specialist to join the clinical hub of the NAS. At present, a go live date of Q3 2019 is envisioned.

E-Mental Health Strategy

4.1 - Families, guardians and carers should be supported in parenting children and young people through the provision of universal, quality-assured and evidence-based parenting information and support programmes.

4.2 - Evidence-based information, interventions and signposting tools about mental

health should be included into routine perinatal care services.

The HSE launched ‘’ last year. This website provides advice, information and support services for mental health and wellbeing.

Crisis textline

The HSE is exploring how to best deliver an active listening service (Live Chat, Instant Messaging & SMS)

HSE Mental Health has engaged with leading US-based provider of instant text messaging support services Crisis Text Line with a view to establishing their service in Ireland. The board of Crisis Text Line has approved the application to extend service licensing arrangements to Ireland. HSE is working in close collaboration with an existing service partner, Creations, to act as the host/incubator organisation for the service on a pilot basis with contractual and service level arrangement negotiations now complete. The risk assessment of the service has been undertaken by Creations. A project manager has been employed and the project plan is being developed and will be complete by mid-February 2019.

Telepsychiatry Pilots

Following a decision of the Project Steering Committee in January 2019, two telepsychiatry pilots are now being undertaken. These pilots encompass the following:

(1) Remote consults to address CAMHS waiting lists.

(2) Remote consults on national adolescent addiction and substance abuse service.

It is also envisaged that a third pilot may be undertaken to assist reducing remote access and creating additional capacity and remote team consultations.

Schools And Youth Mental Health

5.1 - The Department of Education and Skills should support teaching professionals in schools and centres for education with the knowledge and skills to understand their role in supporting young people with mental health issues and how to access information about services and supports available to them.

5.2 - Principals and teachers should be supported to implement the wellbeing junior cycle curriculum.

The Wellbeing Policy Statement and Framework for Practice 2018-2023 was launched by the Minister for Education and Skills in July 2018. The policy statement provides an overarching structure encompassing existing, ongoing and developing work in the area of wellbeing. It builds on the good work already happening in schools to ensure that best practice in whole-school wellbeing promotion is embedded across the system. The policy outlines a multicomponent, whole school preventative approach to the promotion of wellbeing with interventions at both universal and targeted levels. This policy requires that a Wellbeing Promotion Process is developed and implemented, through the use of the School Self-Evaluation (SSE) process, in all schools by 2023.

The policy includes a set of Statements of Effective Practice in relation to wellbeing promotion within the school system. The statements will support schools in reviewing their current provision in four key areas of wellbeing promotion, culture, curriculum, policy and partnership and in setting goals for improvement. In order to support schools in the implementation of this Wellbeing Policy it is planned to develop and rollout a comprehensive programme of professional development, commencing in 2019. This will include facilitating the engagement of schools in the school self-evaluation for wellbeing promotion process, which will build professional capacity in schools. It also includes the provision of a comprehensive and easily-accessible set of resources to address school-identified wellbeing promotion needs. The roll out will be aligned with the Junior Cycle Wellbeing Programme and the Schools for Health Programme delivered through the HSE, Health

The Department of Education and Skills has introduced a new Wellbeing programme for schools which forms part of the new Framework for Junior Cycle. It was introduced to first year students from September 2017. Guidelines on Wellbeing in Junior Cycle have been developed by the National Council for Curriculum and Assessment (NCCA) and are available at Schools will use the guidelines in formulating their individual Wellbeing programmes from September. There will be 400 hours of timetabled engagement for the Wellbeing area of learning over the 3 years of Junior Cycle.

Third level supports

6.1 - The current provision of counselling and mental health supports in higher level institutions should be maintained and enhanced

6.2 - The Higher Education Authority and the Department of Education and Skills should develop appropriate indicators to assess student experience in higher education in the system performance framework for higher education

6.3 - Prioritise the implementation of recommendations contained in “Mental Health Matters”

Community Supports

7.1 - The Task Force recommends that local government work with relevant agencies, youth groups and community groups to provide safe, ‘youth friendly’ spaces, sporting and cultural facilities that are conducive to promoting good mental health. These should include the provision of pleasant spaces and facilities for young people to access qualified health and mental health care in the community.

Evidence-based, quality-assured training in youth mental health should available to all individuals working with young people in the community

The provision of Youth Friendly Spaces in community settings is a high priority for local government. Working with youth groups and community groups, service providers have been asked to try to include youth friendly spaces so that mental health can be supported. The thrust of Government policy has been towards enhancing mental health support in the community since ‘A Vision For Change’ was adopted in 2006. This policy will be continued when the refreshed policy is published later this year.

Accessibility and Alignment

8.1 - Pathfinder should carry out a detailed assessment of the services and supports currently available in relation to youth mental health, in order to identify gaps in service provision and to scope what improvements could be achieved through greater coordination

8.2 - The HSE should improve provision of mental health supports to young people at the primary care level to reduce the pressure on the tertiary referral services and improve waiting times

8.3 - The HSE should establish a National Lead for Youth Mental Health and a Lead for Youth Mental Health in each Community Health Organisation (CHO) to co-ordinate the provision of services and address gaps in service provision, including out of hours services. The CHO Leads will liaise with relevant agencies to develop appropriate communication protocols, standardised assessment processes and coordination of service provision. This joint working will bring together expert stakeholders to identify and address potential blocks to service provision and seek to reduce current wait times nationally with the introduction of other more appropriate interventions in primary care.

DCYA and the Department of Health established a Working Group in 2018 to scope connectivity in the area of youth mental health. The group is made up of senior officials from both Departments with representatives from Tusla, the Child and Family Agency and the Health Service Executive.

The key objective of the working group is to examine psychological and mental health services for children and young people with the aim of agreeing a clearer continuum of provision and strengthening alignment between providers.

Tusla and the HSE have in place both a Memorandum of Understanding and a Joint Protocol for inter-agency collaboration among the two organisations. Discussions are ongoing between the two organisations to ensure collaboration is effective and sustained.

A key initiative that will inform the further advancement of the work of the group is the Youth Mental Health Pathfinder Project, and it is important that the Working Group align with this initiative. Centralising the work in this way will provide a clear overview of existing provision and proposed plans from across the relevant departments and agencies so as to identify gaps in provision, areas of alignment and areas for further development.

Part of the recommendation refers to recruitment of HSE leads but the job specifications for full time staff are hard to define. At a recent meeting with HSE, Task Force representatives and NGO sector it was agreed to wait for the establishment of Pathfinder team to work on specific job specifications for the recommended posts.

Consent Issues

9.1 - Legislation should be published to give effect to the recommendations of the Expert Group on the Review of the Mental Health Act, 2001 with regard to children, including reforming the consent provisions, to allow young people under 18 direct access to mental health services

There are on-going discussions and legislative work in the Department of Health regarding amending the legislation to allow children under 16 access mental health services without the need to have parental consent. Draft Heads of Bill were sent to the Mental Health Commission for their input on 02/07/19. It is expected that the Commission will need approximately six months to review the heads.

Improving Knowledge

10.1 - A funded strategic national research programme on youth mental health will be developed

10.2 - International sources of funding (for example from European Union or philanthropic organisations) should be leveraged to enhance this research strategy on youth mental health research

There have been discussion with the HRB on how best to approach these recommendations. There will be a need for new additional funding and this will need to be tied in the with the creation of the Pathfinder Team who will have responsibility to create structures for administering grants and creating criteria for issuing research funding.

PRIMERA (Promoting Research and Innovation in Mental hEalth seRvices for fAmilies) programme of research, funded by the HSE, is investigating how best to deliver mental health services and interventions to families where a parent has a diagnosed mental illness. Recent years have seen growing recognition of the importance of parental mental health and the need for more integrated and effective service responses to parents with mental illness and their children (Wilson et al., 2010; HSE, 2015). This research aims to:

1. To identify mental health services in Ireland that currently deliver, or are interested in developing and delivering family-focused intervention(s) for families where a parent has a diagnosed mental health problem (and their children aged 0-18years).

2. To subsequently investigate in more detail the implementation and effectiveness of selected interventions in order to inform a ‘think family’ care delivery agenda in Ireland (and internationally).