Dáil Éireann Debate, Wednesday - 18 October 2023
268. Deputy Martin Browne asked the Minister for Health if the provisions of Budget 2024 will see an increase in services for people with eating disorders; if he has made any provision for the development of a specific model of care for avoidant restrictive food intake disorder; and if he will make a statement on the matter. [45569/23]
Amharc ar fhreagraThe total allocation for mental health services for 2024 is almost €1.3bn, a record funding level which represents an increase for the fourth year in a row. As part of the additional funding secured under Budget 2024, a number of new posts will be available to support youth mental health service provision and development. This includes posts to support eating disorders, as well as across dual diagnosis and early intervention psychosis. Funding will also be used to ensure the strategic development and alignment of key services that are relied on by young people and their families.
In relation to eating disorder services specifically, the HSE has prioritised eating disorder (ED) services as part of its National Clinical Programmes (NCP) which aim to develop high-quality, person-centred, integrated care through a clinician-led, evidence-based approach to service reform.
While a small number of people benefit from more intensive treatment through day programmes or inpatient care, the most effective treatment setting is in the community. Dedicated community-based eating disorder services, where multidisciplinary teams have specialist training, can provide evidence-based care and treatment.
The HSE also funds patients in private facilities based on individual clinical need, as assessed by the local mental health team, and the prioritisation of available funding.
In January 2018, the HSE published a National Model of Care for Eating Disorders (MOC) in partnership with College of Psychiatrists’ of Ireland and Bodywhys. This Model of Care was developed to guide the provision of high quality, accessible and value for money eating disorder services in Ireland. Key recommendations include:
• the development of a national network of dedicated eating disorder teams embedded within the mental health service
• a stepped model of outpatient, day patient and inpatient care provision based on clinical need
• the development of a skilled, trained workforce
The National Clinical Programme for Eating Disorders (NCPED) aims to establish an ED network (8 adult teams and 8 CAMHS teams) in accordance with the agreed Model of Care 2018. These multidisciplinary teams provide specialist eating disorder assessment and treatment in the community and are the foundations of delivering quality eating disorder care across the stepped model of care. Today there are 10 NCPED teams at various stages of development across the HSE.
In the context of the significant physical morbidity associated with eating disorders, this Model of Care also recommends a strong integration between primary care, mental health services and medical teams, including the bridging of the acute hospital and mental health service divide through mutual clinical commitments and shared pathways. Recently consultant paediatricians sessions have commenced in 2 community eating disorders teams to facilitate shared pathways. Children and adolescents with eating disorders can access treatment through CAMHS community teams. There are currently 73 CAMHS teams nationwide.
The Department of Health will undertake detailed discussions with the HSE in the coming months to finalise the Mental Health element of the new HSE Service Plan 2024.
With regard to the Deputy’s specific query around avoidant restrictive food intake disorder, this is a service matter and I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
