I thank Members for the opportunity to update them on developments in my area of responsibility, which covers mental health and services for older people.
The protection of the vulnerable continues to be a priority for the Government, especially in these challenging times. We recognise that those with mental health issues and older people are often among the most vulnerable in society.
While much has been achieved in mental health in recent years, largely due to a welcome and broad consensus both inside and outside of the Oireachtas, much remains to be done. We are fortunate in Ireland to have in place fundamentally robust legislation, policies and services that have been built up over time and which, overall, compare favourably internationally. More importantly, there are identified and widely agreed pathways to undertake further improvements on all these fronts, including improved residential and community-based care for children and adults and psychiatry of later life.
In terms of mental health, my objectives right now are to progress the commitments reflected in the Programme for Government: Our Shared Future, and also to maximise the response of the mental health system to the evolving issues posed by Covid 19. I am, for example, progressing the update of the Mental Health Act 2001. I am determined that the legislation required to open the new forensic mental health facility at Portrane to replace the Central Mental Hospital in Dundrum is completed as quickly as possible. This significant and modern facility is expected to open early next year.
The establishment of the monitoring and implementation committee to oversee the new policy, Sharing the Vision – A Mental Health Policy for Everyone, is well advanced. This will be key to building on the fundamentals of A Vision for Change, driving new service developments and instigating new approaches to delivering some existing services through, for example, the greater use of digital technologies. I intend to increase, as overall resources allow in future years, the €1 billion or thereabouts given to the HSE this year to maintain and develop its wide range of mental health and suicide prevention services. These span all specialties and ages, from mental health promotion and early intervention to acute inpatient care and clinical programmes such as self-harm or eating disorders. Improving access and reducing waiting lists, where possible, are key objectives for the Government, notwithstanding acknowledged difficulties and the greatly changed operational environment posed by Covid-19.
Hopefully, the opportunities posed by the new policy, new infrastructure, increased training places and new technologies will assist in improving recruitment and retention rates in geographic areas of the country where these have, for whatever reason, traditionally been below the national average.
Since becoming Minister of State, I have met various mental health groups and advocates and visited services on the ground. I intend to meet and visit many more, Covid restrictions allowing. While I accept the scope for improvement on many fronts, my experience so far has been that the passion of advocates is matched by the dedication and professionalism of our mental health and other care staff to deliver the best possible service, often in the face of increasing demand and unprecedented circumstances. Some of the negative stories I hear do not correlate with the positive reality on the ground.
As I have indicated, work continues on draft heads of a Bill to revise the Mental Health Act 2001. These relate, for example, to revised criteria for detention, new definitions of mental illness and treatment, improved safeguards for change of status from voluntary to involuntary patient and the treatment of children under the Act. This process takes into account Ireland's international obligations, such as the ratification of the Convention on the Rights of Persons with Disabilities, as well as recent legislative changes in Ireland, including the Assisted Decision-Making (Capacity) Act 2015, and proposed protection of liberty safeguards. These changes and others, when included in revised mental health legislation, will further improve the protections available to mental health service users.
The implementation and monitoring committee envisaged under Sharing the Vision – A National Mental Health Policy for Everyone will be representative of relevant stakeholders, including service users, which is extremely important. It will drive reconfiguration, monitor progress against outcomes and deliver on commitments made in the new policy.
I would like to highlight, in particular, the issues posed by Covid-19. The pandemic is understandably a source of significant stress, anxiety and fear for many people. This arises from the disease itself, as well as from impacts such as increased social isolation, disruption to daily life and uncertainty about employment and financial security. Just as effective physical measures can be taken to limit the impacts of Covid-19, there is simultaneously much that can be done to promote resilience, protect mental health and aid recovery, where this is necessary. It should be remembered that other serious diseases and illnesses can potentially lead to mental health pressures that are often also positively addressed.
All levels of the HSE mental health service, in conjunction with many State and other agencies, will continue to respond in the best possible way to Covid-19. We all want to ensure that services continue while at the same time introducing more tailored measures to deal with mental health needs during and following the pandemic. It is worth noting, in terms of the effects and challenges of Covid-19 on our mental health system, that approximately 90% of supports were continued during lockdown. In addition, a blended approach to service delivery was quickly adopted by many organisations and that will help inform greater clarity around the roles and responsibilities throughout the sector in the future. I thank the many organisations that have acted very quickly.
Approximately €1.1 million has been provided for a mental health promotion and well-being campaign, through enhanced online supports funded by the Sláintecare integration fund. This funding has been used by the HSE to further update the mental health signposting website www.yourmentalhealth.ie. The funding enhanced psychological oversight of the new free national crisis text line, provided free online counselling for those affected by Covid-19 through MyMind and peer group support for healthcare workers and medical staff. A further €1.1 million is supporting the HSE psychosocial strategy. This will enable the healthcare system to plan additional integrated solutions to augment existing interventions funded to date.
HSE mental health services have a proven response model in place for monitoring and safely delivering services to the maximum level possible in pandemic circumstances, for both community and residential services. The Mental Health Commission will continue to play an important role in helping to monitor and combat Covid-related issues in mental health centres under its ambit. The Department will continue to work with both the HSE and the Mental Health Commission to ensure the evolving situation is monitored and any required actions are taken as fast as possible.
We have been working with the Department of Education to provide a collaborative approach to assisting leaving certificate students and their families in dealing with the additional anxieties associated with cancelled examinations and the return to school or going to college. A guidance document and list of supports have been developed for parents and teachers. The website www.gov.ie has been updated and provides a good starting point for any student, parent or teacher looking for information on what is available during this difficult time. I am conscious today of all the students waiting for their first round offers from the Central Applications Office on Friday.
The impact of Covid-19 on society in general, but on older people especially, has been considerable. Older people have made huge sacrifices to protect themselves and the rest of society. We, as a country, owe them a debt of gratitude for their selfless action. I am acutely conscious of the grief people have experienced over the past six months. I offer my deepest condolences to all those who have lost loved ones.
Maintaining our well-being and resilience in these challenging times has not been easy. Our lives have changed dramatically over the past six months. We have all had to adapt to a new normal that is different for every one of us. Perhaps the biggest changes have been experienced by those most at risk, namely, older people and those with underlying conditions. My Department and the National Public Health Emergency Team have, from the outset, focused on them, establishing a subgroup on vulnerable people as part of our early response to the pandemic. The subgroup has provided oversight and assurance with regard to the measures required to protect vulnerable groups from the virus to the greatest extent possible. Specific guidance for the over-70s and medically vulnerable has been provided by the Health Protection Surveillance Centre and is available on its website.
The Government's In This Together campaign has provided lots of tips and advice on looking after mental well-being, staying active, eating well and staying connected, drawing together a range of activities that can be pursued at home or locally, alone or with family members or friends online. The campaign has simple key messages on staying connected and creating a routine in addition to tips on stress reduction and links to services providing a valuable and vital resource of trusted information in one place. Through social media channels, the campaign called on those who were aware of vulnerable people in their locality to ensure they were checked on and looked after, either through helping with groceries and shopping or helping them to link in with relevant services.
The Community Call initiative has mobilised resources and community initiatives to support those who have been cocooning to help them to gain access to services. Community Call has been supported by local authorities, An Garda, the GAA, other sports organisations and community volunteers. As part of this, each local authority established a helpline that vulnerable people can phone if they are looking for basic services, such as the delivery of food or meals, or transport for essential trips.
Just 30 minutes of activity per day could have a great impact on one's health. Resources such as those provided through the In This Together campaign, Sport Ireland and other partners have been very valuable in promoting the need to remain sufficiently active even when restricting the number of contacts or cocooning. Our clear message is that whatever people are going through owing to reduced social contact or isolation, we should all stay as connected as possible, thus helping to strengthen community and individual resilience and restoring hope that we can and will recover. We will make it through this together.
Supporting older people to remain in their own homes and communities, live with dignity and independence and to be engaged in their communities is a key tenet of Government policy. We are committed to the development of improved committee and home-based services, shifting care to homes and offering greater choice for older people. This includes the development of the statutory home care support scheme, in addition to developing and enhancing services, such as reablement to support people to live at home for as long as possible and to reduce reliance on care in congregated settings.
Work is ongoing in the Department to determine the optimal approach to the development of the statutory scheme within the broader context of the ongoing reform in Ireland's health and social care system, as envisaged in the Sláintecare report. This work has been informed by stakeholder engagement, which will continue through the development of the scheme. The HSE continues to work closely with providers and community staff to identify where a service is most required and has been undertaking risk assessments of local services. This is to ensure, in so far as possible, that day care centres can resume in the context of Covid-19 and having regard for public health advice. Day care services will resume when safe and when all infection prevention and control measures and the requirements of physical distancing can be maintained so as to protect service users and staff and to prevent any further spread of the virus. Some centres may not be suitable owing to the constraints of the physical environment, and it will be necessary to continue or expand alternative service delivery models developed during recent months. I am deeply aware of the impact of the continued delay in the reopening of day centres on older people and the important role a day care service can play in their lives. I have asked the HSE to ensure that it will continue to assess the risks and benefits of reopening, in addition to continuing to expand and explore alternative ways of delivering services to this vulnerable group. I am continuing to meet the groups that work with and on behalf of older people to determine how older people can best be supported during these challenging times.
The Covid-19 nursing homes expert panel report was published on 19 August. The report contains 86 recommendations in total and over 15 thematic areas, with associated timelines for implementation over the short, medium and longer terms. We have established an oversight structure to ensure the implementation of the important recommendations contained in the report. This encompasses the establishment of both an implementation oversight team and a reference group.
I am acutely aware that Covid-19 and the resulting national and local lockdowns generated specific challenges for people with dementia and family carers. Day care and respite services have been suspended and the usual routines have been disrupted, creating additional pressures for service users and their families. The HSE has adapted its community services to provide a flexible response so the needs of people with dementia continue to be met during the Covid-19 crisis. Primary care team support is operating nationwide, with referrals being made to community supports, including the Alzheimer Society of Ireland's dementia advisory service and the local authority community response forums. The HSE's memory technology resource room network has been centralised, with advice and video assessments provided by telephone and online.