Mental Health: Statements

This approach informed A Vision For Change in 2006, which set a new direction for the delivery of mental health services. This policy took an holistic view of mental illness and championed an integrated multidisciplinary approach to address the biological, psychological and social factors contributing to mental health. It also advocated an increased emphasis on recovery and the destigmatising of mental illness. Outdated institutions were replaced with modernised centres, some of which are today attached to our acute hospitals to ensure quick and easy access to medical facilities, as required.

Community teams were, and continue to be, enhanced in order to treat patients as close to their home as is practical. There are now 114 adult mental health teams and 70 child and adolescent teams embedded throughout the nine community health organisations around the country.

The refresh of A Vision for Change will continue this work. In line with Sláintecare, it aims to improve both service user and clinician experience to ensure a better outcome, while ensuring value for money. The HSE's New Ways of Working that were recently installed across our health services will support the implementation of the Vision for Change refresh in order to deliver our health services as close to people's homes as possible, with the majority of care delivered within the community and not in acute hospitals.

The refresh of A Vision for Change is expected to be presented to Government for consideration before the end of the year. Given the significant increases to the mental health budget over recent years, this policy will focus on a reconfiguration of existing services to best suit individual need. As part of this, all current and future mental health spending will be critically evaluated to ensure cost-efficiency and value for money. In this regard, the Department and the HSE will continue to work to develop innovative ways of delivering mental health services to ensure as many people as possible are treated in as timely a manner as possible.

Over recent years, I have prioritised a number of initiatives and have worked with the HSE to introduce new ways of working which will complement the delivery of mental health services, while easing the burden on the service. Some of these initiatives, which are being driven by the Department of Health, centre on digital technologies. Telecounselling and telepsychiatry projects will provide remote counselling and psychiatric consultations that will help to improve access to mental health services. A dedicated mental health signposting telephone number will be launched by the Taoiseach later this month and a crisis text line will be launched early in the new year. Greater use of the technology available to us will help to deliver services at as early a stage as possible and will help to ensure that mild mental health issues are dealt with before they become more serious.

We have also enhanced mental health services provided in primary care. The introduction of 114 assistant psychologists and 20 psychologists in primary care has resulted in an increase of 28% in referrals, which will total approximately 14,000 in 2019. This, in turn, has helped to reduce the national waiting list for child and adolescent mental health services, CAMHS, to around 2,000, a decrease of 500, or 20%, since December 2018.

These initiatives exemplify the serious intent of the Government to progress and improve mental health services. This intent is further demonstrated by the investment in the 170-bed state-of-the-art complex in Portrane that will replace the Central Mental Hospital in Dundrum. This will address capacity issues which have emerged in recent years by increasing the number of beds from 103 to 130 beds and will completely modernise the forensic mental health service in Ireland. In addition, a ten-bedroom forensic child and adolescent mental health unit and a 30-bedroom intensive care rehabilitation unit will be co-located on the site.

The amendment of the Mental Health Act 2001 remains a priority for the Government. A major review of the Act is currently under way and work is continuing in earnest. The recommendations from the expert review group have been taken on board by the Department of Health within this review process and are reflected in the draft heads of Bill prepared by the Department. Earlier this year, the Department furnished the draft heads to the Mental Health Commission for examination. It is essential that the commission be given enough time to fully consider the draft and to provide its expert opinion. The Mental Health Commission expects to complete its review of the draft in early 2020, at which point further work will be required by the Department to consider and revise the heads based on the views of the commission. When this work is completed, the revised heads will be submitted to Government for approval to finalise the text of the Bill. It is expected that the final text of the Bill, as approved by Government, will go before the Oireachtas in late 2020.

The ongoing reform agenda in mental health has led to much-needed change on many fronts, including the continued destigmatising of mental illness, a greater recovery focus and the encouragement of more open discussion. Delivering modern mental health services requires adequate resourcing but it also requires a new outlook to maximise the impact of existing structures and service provision. I look forward to the continued reform of our mental health services and welcome contributions from Members to this discussion.

Is there a copy of the Minister of State's speech?

There is. I have not given it to the ushers. I apologise.

I will be sharing my time with Deputy Rabbitte. We will be taking five minutes each. I am glad that we are taking statements on mental health tonight and that as a Dáil, we are keeping mental health on the agenda. I welcome the opportunity to again discuss mental health in this Chamber. It cannot be discussed enough. I acknowledge there recently have been a number of positive developments in mental health including the new 24-hour mental health helpline, the development of a number of clinical programmes, and the building of the forensic mental health hospital at Portrane. There are, however, also some serious areas of concern. I refer, in particular, to the many failures to implement policy within our mental health services. It is now 2019, some 13 years into A Vision for Change, our ten-year national mental health strategy. Many of the issues faced by patients and their families are totally unacceptable and unnecessary. I will highlight some of the issues concerning people.

First, I will raise the issue of our child and adolescent mental health services, CAMHS. This is our acute mental health service for children and adolescents, which addresses the 10% that make up the most acute circumstances that affect our young people's mental health. These services are seriously understaffed. Only 57% of the staff number recommended in A Vision for Change are in place. In two areas, CHO 5 and CHO 7, fewer than 50% of the necessary staff members are in place while only 7.6% of the necessary staff are in place for children with intellectual disabilities.