Dáil Éireann Debate, Wednesday - 17 September 2014
786. Deputy Michael Conaghan asked the Minister for Health if he will provide a progress report on the recommendations in the A Vision for Change report regarding drug users; the reason many of the services in the Vision for Change report are not being delivered to this vulnerable group of persons; and if he will make a statement on the matter. [33028/14]
Amharc ar fhreagra888. Deputy Finian McGrath asked the Minister for Health if he will provide a progress report on the A Vision for Change recommendations regarding drug users; the reason two sections of the Health Service Executive are not working together to deliver services to this very vulnerable group of persons; and if he will make a statement on the matter. [33364/14]
Amharc ar fhreagraI propose to take Questions Nos. 786 and 888 together.
A Vision for Change(2006) sets out a comprehensive framework for the development of all mental health services. It recommends, broadly, a move away from the traditional institutional based model of care to a more patient-centred, flexible and community based service, where the need for hospital admission is greatly reduced while still providing in-patient care, as appropriate. This Government has prioritised the reform and resourcing of our mental health services in line with A Vision for Change, and has significantly progressed this through the provision of €90m since 2012 to underpin a range of new services initiatives to meet this widely agreed strategy objective.
As indicated in A Vision for Change, the key responsibility for the care of people with addiction lies with Primary Care Services, to include appropriate liaison with Mental Health services.
In this context, I am satisfied that there exists appropriate cooperation between HSE Mental Health Services, Addiction Services, Drug Task Forces and other Community and Voluntary agencies to deliver the type of services raised by the Deputies. This includes provision of specific funding by the Executive to a number of voluntary service providers that treat drug and alcohol disorders.
The responsibility of community mental health services includes responding to the needs of people with mental illness, and an addiction. Acute presentation by service users with co-morbid mental health and addiction problems are recommended to be seen by General Adult Community Mental Health Teams or, if needs be, by the Child and Adolescent Mental Health Service (CAMHS), which provides acute secondary care interventions in the community.
There are currently 115 General Adult Community Mental Health Teams. A Vision for Change recommends that there should be 92 to service the population (i.e. 1 per 50,000). The reconfiguration and development of these teams are continuing, in line with A Vision For Change recommendations. There are currently 62 CAMHS Teams, representing an increase of 4 on the same period last year. In addition, there are also 3 CAMHS Day Hospital Teams, and 3 Paediatric Liaison Teams. Of relevance also, is the fact that there are currently 24 Psychiatry of Old Age Teams, an increase of 2 over last year.
In the overall context, A Vision for Change recommends the provision of specialist community mental health teams for those with complex and enduring mental illness, together with co-morbid substance abuse issues. The focus of the HSE is to develop the General Adult, Psychiatry of Old Age, and Child and Adolescent Community Mental Health Team structures nationally, including that potentially relating to those with co-morbid substance abuse problems. The HSE Mental Health Division recognises the obvious need for effective liaison between Primary Care, and Community Mental Health Teams. It is intended that these links will be strengthened, as additional staffing is recruited.
The National Drug Treatment Centre, based in Trinity Court in Dublin, also provides a Specialist Dual Diagnosis service for people affected by both Mental Illness and Addiction. Its programmes are available for the greater Dublin region, and to certain other areas, as required. It also provides a Young Persons Programme (YPP), which has proved very successful over the last number of years.
As capacity is expanded within Community Mental Health Teams nationally, in conjunction with enhancing Clinical Programmes, the HSE Mental Health Division will consider further development of specific specialised resources. In 2014, the focus is on building on investment in Mental Health Intellectual Disability (MHID), Liaison, and the Homeless with mental health issues, as well as improvements to the more generic community mental health teams.
Notwithstanding the various pressures and difficulties being faced by the health and personal social services overall, I am satisfied that the HSE is maximising its efforts to provide a more co-ordinated approach to the type of services raised by the Deputies. This will be improved, as appropriate, in the future in the context of progressing wider health service reforms whether at national or local level. If the Deputies have specific concerns about services at local level, this should be raised with the HSE in the first instance, which has statutory operational responsibilities for resolving particular issues.
