Written Answers Nos. 724-743
724. Deputy Mark Ward asked the Minister for Health the areas in which the €12 million allocated for existing mental health services in budget 2021 will be spent; and the reserves in place if this funding is not sufficient to meet the demand. [31565/20]
Amharc ar fhreagraThe Government is firmly committed to developing all aspects of mental health - legislation, policies and services. To maintain improvements to services in recent years, Budget 2021 saw an additional €50 million allocated to HSE Mental Health Services, bringing the total budget to €1,076 billion. This is the biggest mental health budget noted to date and signifies the Government’s continued commitment to mental health and the priority it deserves, particularly in these unsettling times.
€23 million is for implementing the short-term costs of Sharing the Vision in 2021. Some of these costs include the provision of additional beds, enhancing mental health teams, expansion of the clinical and dialectical behavioural therapy programme, peer support workers and the IPS employment and training initiative.
€15 million will assist with the challenges arising from Covid-19. The number of step-down beds will be increased and extra resources will be provided for community mental health teams. Reconfiguration of mental health facilities will also take place, in line with Mental Health Commission recommendations.
The remaining €12 million will help to cover the rising cost of existing service provision, including operational costs and placements for those patients whose needs cannot be met within the public mental health system.
It is expected that this additional €12 million will be sufficient to meet these increased costs.
726. Deputy Mark Ward asked the Minister for Health the recommendations in Sharing the Vision that will be financed by the €23 million allocated for this purpose in budget 2021. [31567/20]
Amharc ar fhreagraBudget 2021 saw an additional €50 million allocated to Mental Health Services, bringing the total 2021 mental health budget to €1,076 billion, which is the biggest mental health budget noted. This signifies the Government’s continued commitment to mental health and the priority it deserves in these unsettling times.
€23 million has been allocated for implementing the short-term recommendations of Sharing the Vision in 2021. This includes the provision of additional beds; enhancing mental health teams including CAMHS hubs/teams, adult crisis resolution teams; expansion of the clinical and dialectical behavioural therapy programmes; peer support workers and the IPS employment and training initiative.
€15 million will assist with the challenges arising from Covid-19. The number of step-down beds will be increased and extra resources will be provided for community mental health teams. Reconfiguration of mental health facilities will also take place, in line with Mental Health Commission recommendations.
The remaining €12 million of the additional €50 million additional mental health funding for 2021 will help to cover the rising cost of existing service provision, including placements for those patients whose needs cannot be met within the public mental health system.
Sharing the Vision was launched in June 2020. The policy promotes equitable access to quality, safe mental health care for all citizens. Service users and their families, carers and supporters will have timely access to evidence-informed mental health services. Tailored measures will be put in place to ensure that individuals with complex mental health difficulties can avail of services across the State without discrimination. This builds on the intent of A Vision for Change and Sláintecare and is expected to be implemented as part of a ten-year plan.
Sharing the Vision recognises and plans for the increasing need for mental health services and demand for more holistic person-centred responses. The ten-year plan addresses population needs through a focus on the requirements of individuals. It promises early intervention, with a focus on prevention and positive mental health promotion. This focus advocates a mental health system that works in partnership with service users and their families to deliver a range of integrated services and supports.
The attached breakdown indicates in more detail the service priorities for 2021 and aligns those priorities to the recommendations contained in Sharing the Vision.
Sharing the Vision Recommendations for Budget 2020/2021
|
Initiative |
Description |
Recommendation |
|
Additional Mental Health beds |
This initiative is to increase number of step-down beds available in the community due to the reduction in capacity as a result of COVID-19. |
38, 46, 50 |
|
Enhanced Mental Health community teams |
Sharing the Vision states that the cornerstone of service delivery in secondary care will continue to be the multi-disciplinary Community Mental Health Teams (CMHTs). Funding will be provided to provide additional staff for community teams. |
13, 17, 20, 25, 26, 28, 30, 32, 33, 34 |
|
CAMHS Hubs/Teams |
StV encourages access to evidence based digital health interventions. Tele-psychiatry models can provide 24-hour psychiatry consultations to service users of all ages who can access supports from a variety of locations such as primary care centres, GP practices and VCS services. Funding will replicate existing models to provide remote access to tele-psychiatry interventions. |
2, 31 |
|
Adult Crisis Resolution Services |
Crisis Resolution (CR) offers after-hours and urgent mental health assistance. This funding will enhance Crisis Resolution Services within Adult Mental Health Service by increasing home-based Crisis Resolution Teams and piloting Crisis Cafes nationally to provide intensive, time-limited support with 7/7 access and connection to other care providers/GP to support recovery and prevent hospital utilisation. |
24, 40 |
|
Clinical Programmes - Dual Diagnosis teams |
Access to primary care addiction services and existing mental health supports when there is a co-existing mental health/addiction problem remains complicated. Specialist Dual Diagnosis teams will offer those with moderate to severe Dual Diagnosis addiction and mental health interventions based on individual need. |
57 |
|
Clinical Programmes - Early intervention programme |
The HSE National Clinical Programme for Early Intervention in Psychosis has the potential to transform the lives of people with emerging or first-episode psychosis. Multi-disciplinary training in behavioural family therapy and specialist cognitive behavioural therapy (CBT) for patients with psychosis will increase positive outcomes. |
20, 53 |
|
Clinical Programmes - MHID |
As described in AVFC, mental health and intellectual disability (MHID) teams should be developed to provide population-wide coverage and ensure fair and equal access to mental healthcare for people of all ages with an intellectual disability (ID). This funding will support the ongoing development of specialist, multi-disciplinary, community MHID services for adults and children providing an effective response to moderate to severe mental illness, deliver quality care and promote recovery. |
50 |
|
IPS workers |
Individual Placement and Support (IPS) is an evidence-based approach to helping people with acute mental health challenges enter the labour force. It is internationally accepted to be the most effective approach to supporting people with significant mental health challenges to gain access to mainstream employment and to helping them to progress on their recovery journey. Funding to mainstream this positively evaluated project is proposed. |
71 |
|
Peer support workers |
The further deployment of Lived experience in peer support roles as part of local CMHT’s and services to enhance recovery outcomes for individuals and families and to increase the recovery orientation of services in line with ‘Sharing the Vision’ and the ‘Framework for Recovery in Mental Health’. This initiative proposes to expand peer support working on adult teams, enhance support services for families, and develop recovery focused services within CAMHS. |
15, 21, 39 |
|
Bereavement co-ordinators CfL |
Sharing the Vision recognises that major life events can be compounded by significant additional pressures that contribute to poor mental health. It is important to ensure that during and following Covid-19, supports are in place for those who have lost loved ones through suicide. This funding will ensure that those bereaved by suicide will have access to information resources, supports and counselling. |
15, 21, 39 |
|
Clonmel Crisis house |
The need for alternatives to hospital admission featured in Sharing the Vision as a major priority. Funding a crisis house offers individuals experiencing acute mental health difficulties access to a service that acts as gatekeeper to hospital beds by ensuring that every individual referred for in-patient admission receives a comprehensive inter-disciplinary assessment before a decision is made about admission to an inpatient unit in a hospital. |
24, 40 |
|
DBT |
The further development of access to talk therapies is promoted in Sharing the Vision. Several online supports have been piloted in the past number of years and have proven to be effective interventions especially during the pandemic. Dialectical Behaviour therapy is an evidence-based treatment option that holds the most evidence for the efficacy and effectiveness in terms of treatment for borderline personality disorder. Access to additional DBT is in line with StV priorities. |
Talk Therapies Various |
|
Sharing the vision - setting up structures |
To ensure ongoing operational implementation of recommendations contained in Sharing the Vision on a day-to-day basis, it is proposed that the HSE establish a structure to assist the NIMC in driving implementation of the policy. This work will require administrative support to assist the NIMC and the various sub-committees with their work. |
76, 99 |
In addition, the establishment of a National Implementation and Monitoring Committee (NIMC) to oversee implementation of the policy was recently approved by Cabinet and announced by Minister Butler. The Committee will be mandated to drive reconfiguration, monitor progress against outcomes and deliver on the commitments made in this policy. Planning for the establishment of the NIMC and associated implementation structures is underway.
727. Deputy Pádraig Mac Lochlainn asked the Minister for Health if a guarantee will be given that the mental health services day centre at St. Conal's Hospital, Letterkenny, County Donegal, will reopen when Covid-19 restrictions are lifted. [31579/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
728. Deputy Sean Sherlock asked the Minister for Health the number of ambulance calls by county in which the ambulance had to leave its county base; the county the ambulance travelled to; and the time involved for such calls in tabular form. [31580/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
729. Deputy Neale Richmond asked the Minister for Health his plans to update the regional respite services provided by an organisation (details supplied) and increase service hours to the community; and if he will make a statement on the matter. [31589/20]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
730. Deputy Mark Ward asked the Minister for Health the estimated cost to provide ASIST suicide awareness training to 12,000 sports clubs on the basis of ten, 20, 30 and 40 persons per club; and if he will make a statement on the matter. [31591/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
731. Deputy Mark Ward asked the Minister for Health the estimated cost to provide SafeTalk suicide prevention training to 12,000 sports clubs on the basis of ten, 20, 30 and 40 persons per club; and if he will make a statement on the matter. [31592/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
732. Deputy Mark Ward asked the Minister for Health the estimated cost to provide SafeTalk suicide prevention training to 430,000 volunteers, coaches and extended staff in sports organisations; and if he will make a statement on the matter. [31593/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
733. Deputy Mark Ward asked the Minister for Health the estimated cost to provide ASIST suicide training to 430,000 volunteers, coaches and extended staff in sports organisations; and if he will make a statement on the matter. [31594/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
734. Deputy Mark Ward asked the Minister for Health the estimated cost to design an applied intervention mental health workshop to be delivered to coaches, volunteers and extended staff in the sports sector; and if he will make a statement on the matter. [31599/20]
Amharc ar fhreagra735. Deputy Mark Ward asked the Minister for Health the estimated cost to develop an e-learning mental health workshop to be delivered to coaches, volunteers and extended staff in the sports sector; and if he will make a statement on the matter. [31600/20]
Amharc ar fhreagra736. Deputy Mark Ward asked the Minister for Health the estimated cost to develop a mental health coach education module to be delivered to coaches, volunteers and extended staff in the sports sector; and if he will make a statement on the matter. [31601/20]
Amharc ar fhreagraI propose to take Questions Nos. 734 to 736, inclusive, together.
It is not within the remit of the Department of Health to develop education modules or workshops for sports coaches, volunteers and extended staff. However, I have instructed my officials to consult with the HSE on the feasibility of developing a mental health well-being training programme. This would require collaboration with the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media, which is currently developing a National Physical Activity Plan and has responsibility for a number of actions under Connecting for Life, including training in mental health well-being.
737. Deputy Richard Bruton asked the Minister for Health if his attention has been drawn to the disruption caused to the provision of disability services for an organisation (details supplied), which faces a legacy debt; and if his Department could develop an agreed service development plan sensitive to the organisation's service users to get them through this difficult period, which is modified according to the prevailing Covid-19 level. [29794/20]
Amharc ar fhreagraAs part of the overall effort to contain the spread of COVID-19 and in line with public health advice, disability day service locations closed in March. The HSE began planning for the resumption of adult disability day services in May. A group representative of families, service providers and other relevant stakeholders, including Inclusion Ireland, was convened and tasked with the development of a Resumption Plan. On May 31st the Framework for the Resumption of Adult Disability Day Services was published and the guidance to support this framework was published on July 8th.
The guidance is to enable safe and person-centred disability day service supports to be provided in line with current public health advice and infection control guidance. It is not overly prescriptive in terms of detail as there is a wide diversity of disability in the 19,000 adults that received day service supports and day service locations vary enormously in size and capacity. Of this 19,000, approximately 5,000 people receive a day service as part of their residential placement.
The key overarching elements of managing the risk of infection are
1. Processes to identify people (service users and staff) with communicable infection (including COVID-19) before they access services/attend work or as soon as possible after they access services/attend work
2. Processes to minimize the risk of spread of infection from people (service users and staff) who access services/attend for work with unrecognized infection (Standard Precautions)
3. Early detection of spread of infection in the service and immediate response to limit harm
The guidance developed to support the resumption of adult day services also has had to take account of social distancing rules which has meant that there is a reduced number of people in each service location. This means that, when day services re-opened through August and September, they re-opened at 40% capacity. However, the HSE is committed to maximising the support that can be provided within these restrictions. The HSE also plan to capture the detail of the service being provided to each individual over the next few weeks, to get a better understanding of the quantum of service being provided.
The investment of €100 million in the Budget for people with a disability will build the capacity of our adult disability services and increase day services by one day a week, for those whose services were reduced due to COVID-19. It will also support around 1,700 young people who leave school and training programmes in 2021.
In line with the Governments Resilience & Recovery Framework (2020 – 2021), the HSE regards the provision of disability services as essential to maintaining a response to people with a disability, in the same way that schools and creches are. Importantly, Government’s intention is that disability services will remain open at each level of the Resilience and Recovery Framework, subject to public health guidance.
As the Deputy's questions also refers to a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
738. Deputy Neasa Hourigan asked the Minister for Health his plans to examine the regulations and legislation that apply to cannabis use for medical conditions and palliative care; and if he will make a statement on the matter. [31608/20]
Amharc ar fhreagraOne of the Commitments in the Programme for Government-Our Shared Future is to "Examine the regulations and legislation that apply to cannabis use for medical conditions and palliative care having regard to the experience in Northern Ireland and Great Britain" which Departmental officials are currently working on.
On 26th June 2019, the Minister for Health signed legislation to allow for the operation of the Medical Cannabis Access Programme (MCAP) on a pilot basis for five years.
The Programme will facilitate access to cannabis-based products for medical use in line with legislation and with the clinical guidance for the scheme.
Cannabis products will only be listed in Schedule 1 of the Regulations once they have been considered as suitable for use under the Medical Cannabis Access Programme.
The Medical Cannabis Access Programme will make it possible for a medical consultant to prescribe a cannabis-based treatment for a patient under his or her care for the following medical conditions, where the patient has failed to respond to standard treatments:
- Spasticity associated with multiple sclerosis
- Intractable nausea and vomiting associated with chemotherapy
- Severe, refractory (treatment-resistant) epilepsy.
The following specified controlled drug products (cannabis-based products) have been accepted as being suitable for use under the Medical Cannabis Access Programme:
- Aurora High CBD Oil Drops
- CannEpil Oral Solution
- Tilray Oral Solution THC10:CBD10 25ml
A fourth product, Aurora Sedamen Softgels from Aurora Cannabis Enterprises Inc. has also been recommended by the HPRA to be considered for inclusion in Schedule 1 of the Misuse of Drugs (Prescription and control of supply of cannabis for medical use) Regulations 2019, and legislation is currently being drafted to add this product to the regulations.
The programme has not yet commenced while pricing and supply negotiations are ongoing between manufacturers and the HSE.
Ministerial Licence Route
Pending full operation of the MCAP and for medical indications not included in the MCAP, doctors may continue to utilise the Ministerial licensing route pursuant to Section 14 of the Misuse of Drugs Acts 1977-2016 to prescribe cannabis-based products for their patients, should they wish to do so.
In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.
Further information on medical cannabis is available on the Department’s website.
It is important to note that the medical decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process.
739. Deputy Sean Sherlock asked the Minister for Health the status of operations and activity at Mallow General Hospital for June, July, August, September and October to date. [31616/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
740. Deputy Sean Sherlock asked the Minister for Health the waiting times for all children for speech and language therapy by community healthcare organisation, CHO, in tabular form; and the length of time the age group is waiting. [31617/20]
Amharc ar fhreagraThe Programme for Government, Our Shared Future, recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.
The Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
741. Deputy Pádraig Mac Lochlainn asked the Minister for Health the availability of ambulance services in the Inishowen peninsula, County Donegal on a 24-7 basis. [31624/20]
Amharc ar fhreagra742. Deputy Pádraig Mac Lochlainn asked the Minister for Health the number of emergency calls to date in 2020 from residents of the Inishowen Peninsula, County Donegal requesting an ambulance that could not be served with an ambulance because none were available or the closest ambulance was too far away at that time. [31625/20]
Amharc ar fhreagraI propose to take Questions Nos. 741 and 742 together.
As these are service matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
743. Deputy Kathleen Funchion asked the Minister for Health when a person (details supplied) will be receiving speech and language therapy. [31629/20]
Amharc ar fhreagraThe Programme for Government, Our Shared Future, recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.
The Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
