Dáil Éireann Debate, Tuesday - 12 December 2023
830. Deputy Jim O'Callaghan asked the Minister for Health the main initiatives he has taken to develop and expand mental health services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2024; and if he will make a statement on the matter. [55290/23]
View answerThe provision of mental health services are in the main a matter for the Health Service Executive and I have requested the executive to respond to the Deputy directly in this regard. From a policy and budgetary point of view the Deputy may also be interested to note the following progress in areas such as enhancing all aspects of our mental health services and supports remains a key priority for Government. There have been significant improvements in the delivery of our mental health services over the past number of years and the Government is committed to ensuring their continued development throughout this year and into the future. I have outlined in my below response some of the key achievements in mental health in recent years.
The Government’s clear commitment to enhancing mental health services, is shown by significant mental health funding increases in recent years. The total allocation for mental health services in 2024 is approximately €1.3 billion, which is the fourth year in a row in which the mental health budget has been increased. This increase in funding for mental health services represents a significant investment which will enable continued policy implementation and service improvement in line with our national mental health policy, Sharing the Vision. This year’s budget allocation builds on the investment this Government has made over the last number of years to deliver the policy priorities of Sharing the Vision through the provision of mental health supports across a broad continuum from mental health promotion, prevention and early intervention, to acute and specialist mental health service delivery, and enabling us to continue to deliver our vital services to as many people as possible, as we move into 2024.
As part of the funding allocated to mental health services, new development funding has been secured to advance initiatives on youth mental health, and around priority groups identified within our national suicide prevention strategy Connecting for Life. This new development funding will be focused on increased CAMHS staffing, a new Youth Mental Health app, a referral pilot for children's community services including CAMHS (piloting an approach to service referrals known as ‘No Wrong Door’), the expansion of Suicide Bereavement Liaison Services, and expanding the Traveller Counselling Service to achieve national coverage for the first time.
Funding allocated to mental health services in recent years has allowed for the continued investment in the mental health national clinical programmes and models of care, which has led to significant service improvements, including the full implementation of specialist perinatal mental health network provided for and the on-going expansion of specialist mental health teams for eating disorders, ADHD in adults, and dual diagnosis.
Telehealth services are fully established including YourMentalHealth.ie; the information line 1800 111 888, the crisis textline, 50808, and NGO online supports. These include youth specific supports, such as those provided through Jigsaw, SpunOut, and Turn2Me. The majority of telehealth supports are available seven days per week, with some providing 24hour support. In addition, the HSE has partnered with SilverCloud, on a national roll out of digital cognitive behaviour therapy to address depression and anxiety and to make mental health support more widely available.
Importantly, as budgets increase, we need to ensure that we have plans and strategies in place so that those resources are used effectively and efficiently to the benefit of people using our mental health services. All aspects of mental health services are being improved and developed, through Sharing the Vision in the short to longer term. Sharing the Vision aims to enhance the provision of mental health services and supports across a broad continuum, from mental health promotion, prevention, and early intervention to acute and specialist mental health service delivery, during the period 2020-2030.
In terms of implementation and oversight, the National Implementation Monitoring Committee (NIMC) implementation and implementation monitoring structures are well established, enabling policy implementation and governance. The NIMC is made up of the NIMC Steering Committee, supported by a NIMC Reference Group to provide the service user and family member perspective. The establishment of the Reference Group in March 2022 is a key development as it is absolutely vital that people who use our services and their families are at the heart of the design, development and delivery of the systems we build to serve them.
NIMC Specialist Groups, have been established in priority areas of development including Youth Mental Health Transitions, Acute Inpatient Bed Capacity, Women’s Mental Health, Primary Care Mental Health Services and Digital Mental Health.
Sharing the Vision Implementation Plan 2022 – 2024 was published on 23 March 2022. The Plan sets out individual programme pathways of implementation for each of the 100 policy recommendations for the next three years. Additionally, official reporting has commenced with Status Implementation Reports and NIMC Analysis Documents published on a quarterly basis online. As of Q2 2023, 95 of the 100 recommendations are in implementation, with 81 marked on track or with a minor delivery issue.
The implementation of Sharing the Vision will build on existing initiatives already underway, for example in the provision of digital mental health services, the continued phased development and rollout of our national clinical programmes, which are at the heart of service improvement, and the ongoing legislative reform through the review of the Mental Health Act.
In mid-2021, the Government approved a General Scheme of a Bill to amend the Mental Health Act. This General Scheme took into account the 165 recommendations of the Expert Group Review of the Act, the observations of key stakeholders such as the Mental Health Commission and the HSE, the results of a 2021 public consultation wherein 100 submissions were received, changes in domestic legislation, most significantly the Assisted Decision-Making (Capacity) Act 2015, and Ireland’s international commitments, including under the European Convention on Human Rights and the UN Convention on the Rights of Persons with Disabilities.
A Mental Health Bill is now being prepared. The Bill will significantly update existing mental health legislation through, inter alia, the introduction of a set of guiding principles for adults and children receiving inpatient treatment, a revised set of criteria for detention, an overhauled approach to consent to admission and treatment, aligning capacity in mental health legislation with the provisions of the Assisted Decision-Making (Capacity) Act 2015, the introduction of a new, discrete Part on the care and treatment of children, and the introduction of additional safeguards for people receiving inpatient mental health treatment. The finalisation and introduction to the Oireachtas of a Mental Health Bill is a priority for the Government.
The General Scheme of Mental Health Bill was published in July 2021, followed by a pre-legislative scrutiny report published in October 2022. Parliamentary Drafters were initially assigned in January 2022 and new team assigned in January 2023. The Department of Health supporting OPC as it progresses the text of the Bill and is in regular contact with drafters and legal counsel. The Bill was prioritised for drafting in spring, summer and autumn legislative sessions, and work is expected to continue through the end of 2023 to ready Bill for publication.
I was very pleased to announce, in November 2020, the extension of Connecting for Life, our national suicide reduction strategy, by four years to 2024. This followed a recommendation from the independent strategy review conducted in 2018. It reflects the many achievements to date and the hard work and dedication of multiple stakeholders. The National Office for Suicide Prevention responsible for the implementation of Connecting for Life and overseen by the Department has a €14 million allocation. The extension and continued implementation of Connecting for Life demonstrates the government’s commitment to addressing suicide and self-harm in our communities.
Connecting for Life will reach the end of its life in 2024 and a tender has been issued by the HSE to evaluate its implementation. Planning will also soon commence for the successor strategy to Connecting for Life.
Following the Programme for Government commitment, the interdepartmental High-Level Taskforce was established by Government in 2021 to enhance links for those in contact with the criminal justice system accessing Mental Health, Addiction or Primary Care services. Final Report was approved by the Government on 20 September 2022 and was subsequently published. A joint Inter-Departmental Steering Committee has been established to monitor implementation the HTLF report over the next five years. The first annual progress report of this group will be published shortly.
Please see the below table outlining the budget allocation to HSE Mental Health Services since 2020.
Mental Health Funding 2020-2024
|
Year |
Allocation (NSP) - €m |
|
2020 |
1,031.3 |
|
2021 |
1,114.1 |
|
2022 |
1,159.0 |
|
2023 |
1,226.7 |
|
2024 |
1,295.5 |
As occurs each year following the Budget, discussions will now take place with the HSE on details relating to specific service initiatives in the context of preparing the HSE Service Plan 2024, including that for Mental Health.
As the question also concerns operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
