Thursday, 8 November 2012

Ceisteanna (6)

Robert Troy


6. Deputy Robert Troy asked the Minister for Health his plans to change the Mental Health Act in view of recent comments by a person (details supplied); and if he will make a statement on the matter. [48953/12]

Amharc ar fhreagra

Freagraí ó Béal (10 píosaí cainte) (Ceist ar Health)

We have all been made aware of the tragic circumstances involved in this case and I am certain that I speak for everyone in the Chamber in expressing our sincere sympathies and condolences to the family involved. I have met the person concerned on a number of occasions to discuss the circumstances around the tragic incident and received a written submission from her which calls for greater family involvement and mandatory risk assessment in the treatment of people with mental health difficulties. On the basis that the issues raised may be addressed in the context of a legislative review, I have sent a copy of the submission to the expert group established to review the Mental Health Act 2001 for consideration. The group is continuing its deliberations and is expected to produce its report by March next year. I have also brought the submission to the attention of the Mental Health Commission and to the HSE national clinical lead for mental health.

I thank the Minister for her reply. I do not wish to add to the trauma suffered by the family and its community but valid points have been made regarding the fallout of that tragic day. Mandatory assessment of children should be considered in reviewing the Mental Health Act, as children could be at risk. In this unfortunate case there were very tragic consequences and I urge the Minister of State to take this on board. I welcome the fact that she met the person in question and discussed these very tragic circumstances.

I hope the matter will be taken into account in the review of the Mental Health Act 2001. If it is necessary, I hope there is some way of carrying out a risk assessment of children in this kind of environment. I do not want to comment too much as although the names are public, we should be able to deal with this in a very sensitive way to address the concerns of the woman in question, as well as the many other people who may be faced with a difficulty in the form of children or other people suffering such depression.

I thank Deputy Kelleher for showing such sensitivity. I am never certain if such issues should be discussed in here: people have the right to put down questions but I worry about this topic because it is so sensitive. I have met the person in question on three occasions and been in regular communication with her. One could not help but feel for somebody in such circumstances. It is a case of there but for the grace of God go I. It is an appalling position in which to be.

I have passed everything she said to the expert group and the Mental Health Commission. There are serious difficulties surrounding the matter, and we must be very conscious of patient-doctor confidentiality. I do not know of any doctor, nurse, psychiatrist, psychologist or counsellor who would not intervene if he or she thought for one minute there was a risk to anybody's life. We must believe that and accept it as fact. We should await the findings of the review group.

I will not deal with the details of the case as I do not have that information. I will speak to the broader issue of the Mental Health Act. The interim report of the review group of the Mental Health Act was published last June, emphasising the need for revised mental health legislation to support the objectives of A Vision for Change. Will the Minister of State give an indication of when we will see further mental health legislation in line with that recommendation? The Minister of State famously locked away €35 million in a zip pocket in the back of her jeans, or so she told us one day.

I was not quite so explicit.

That has been mysteriously pilfered by hands unknown; I hope the owner of those hands is not sitting too close.

That would be a brave man.

There was a briefing yesterday in the audiovisual room by Mental Health Reform. Those people indicated they were still hopeful that at least a portion of the €35 million would yet be expended in the current year on the signalled recruitment spoken about. Will the Minister of State give us some hope that this will be realised before 31 December and, as previously promised, that a further €35 million will be presented in 2013 to progress the promise of A Vision for Change?

With regard to the specific case, investigations may be carried out, and in the broader sense - and not this particular case - there may be potential shortcomings. Is there any way we can engage independent adjudication of whether proper procedures are carried out if a shortcoming is noticed in an area like mental health in children? If a complaint is made, the HSE would investigate the matter. There is a Garda Ombudsman and if there is a serious complaint about gardaí, that office would investigate. Could such a process take place, even within the HSE but at arm's length? The process should be independent, verifiable and fair.

How much of the €35 million has been spent on recruitment? We have been led to believe nobody has yet signed a contract. Is it the case that the process is being delayed until January 2013?

I may need more time to answer all the questions but I will try to stay within limits. There is an independent group to monitor mental health, the Mental Health Commission, and it has served us extremely well. It looks not only at acute units but advises on guidelines for treatment. The people directly involved in an incident take no part in producing the reports, which are done by people removed from the incident, and we must accept that process. Equally, we must accept that people involved, either on a professional or other level, can be quite traumatised by incidents like this.

We must be careful, given the sensitivities involved.

The 414 posts that we managed to get last year will be in place by 10 December of this year. We would have liked to have had them by September, but there were difficulties in vetting the people we were bringing to Ireland, which was necessary due to a lack of expertise in this country.

Part of the €35 million was for the National Counselling Service, NCS, and that has been spent. It is a counselling service available to general practitioners, GPs, in the primary care setting. Another part of the €35 million was for the National Office for Suicide Prevention and the Genio projects, such as those dealing with dementia and people living well in their own communities. Deputy Kelleher is aware of one such project in Kinsale.

The €35 million is being spent on mental health services. I hate the term "going forward", but ensuring those posts are supported will cost approximately €32 million next year. When the teams are put in place on 10 December, it will not just be a matter of bringing people together. Work will be necessary to make them good, cohesive, functional units if we are to provide the type of service that is desired. However, we will provide that mental health service where people want it, be that in their communities or their homes. The savings from closing the beds in large institutions will accrue to us.

We will always need acute units to deal with people experiencing episodes of acute mental distress. Thankfully, we need fewer of them because we are delivering a different service in a different place.