Paul Connaughton (Galway East, Fine Gael) | Oireachtas source

I am thankful for the opportunity to speak to this debate. The vision which underpins the provision of mental health services in Ireland is based on a model of service where the emphasis is increasingly on service provision in a community setting. Although the ongoing employment of team members for community mental health teams is welcome, it is crucial that the people seeking help receive appropriate treatment in a safe and compassionate setting.

The question that needs to be asked continually is what the experience is of a person with mental health difficulties who presents at the various points of the health service. I understand that 90% of patients who present with mental health difficulties are dealt with in a primary care setting, but what happens to the other 10%? What level of service is presented to these people and what is their experience?

In recent weeks I have been approached by a number of families in County Galway who related their experience of mental health services to me. A major period of transition is under way but it has emerged that communication is a major issue at this time. This specifically concerns communication between community health teams and GPs, and between various health practitioners who may not be fully aware of the workings of the new system.

We cannot allow situations to exist where people experiencing real, acute mental health difficulties are sent from pillar to post because health practitioners are not aware of the changes under way. Greater cognisance needs to be taken of people experiencing suicide ideation who present at the accident and emergency departments of acute hospitals. How are these people treated? Accident and emergency departments are often chaotic places where staff work at a frenetic pace to assess and treat patients. There must be ongoing assessments of the people presenting at these departments, their treatment, the level of service they receive and the time lag between their initial presentation and their next involvement with the community mental health team. This is a crucial juncture. In the former institutionalised setting those patients were in a safe and secure environment but now that treatment is increasingly community-based we must ensure their safety and well-being are not jeopardised at this critical time.

There is huge anger in the Ballinasloe region and further afield at the closure of inpatient beds at St. Bridget’s hospital, in particular at the lack of consultation and clarity around how this decision was arrived at. There is also concern about the pressure this closure will put on the inpatient facility in Galway city. Staff in the psychiatric unit in Galway city have expressed major concern about their working conditions. I want the Minister of State and his colleagues to address those concerns and needs as quickly as possible.

Most, if not all, mental health professionals are in favour of moving treatment from an institutional setting to a community setting. It is crucial, however, that no patient loses out as this period of transition is under way. Every effort must be made at every level to ensure the transition is as smooth as possible. It is only through a properly equipped and staffed service that community health teams can provide the optimum service and it is imperative that a particular focus is placed on staffing levels in the Galway region as this important transition takes place. Much can be learned from regular reviews of patient experiences and while there has been significant engagement with service users and family members efforts on this front must be redoubled during the transition phase such as that under way in east Galway.

I welcome the fact that in recent years there has been a significant reduction in the number of children and adolescents treated in adult psychiatric units. In 2008 a total of 247 children and adolescents were treated in adult psychiatric facilities. Last year this number had reduced to 91. I look forward to the day when no children or teenagers will receive inpatient treatment in an adult psychiatric unit.

Staffing is the key issue in this transition. Recruitment is complete for 95% of the 414 posts allocated in 2012. One third of the posts allocated last year have yet to be filled, although the recruitment process is under way in all cases. The extra 1,100 posts being put in place throughout the country will pay rich dividends in terms of assistance to people with mental health difficulties and their families. This is an investment in people and communities, rather than institutions that is crucial to our future success. Over 250 new posts will be created this year and I urge the HSE to make every effort to ensure these posts are filled as soon as possible. I understand the recruitment has commenced but it must be progressed as quickly as possible to ensure that all available resources are spent on community mental health teams.

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