John Brassil (Kerry, Fianna Fail) | Oireachtas source

I thank the witnesses for attending the committee today. I will get straight to the questions as time is limited. I want to get the maximum from the time allocated. A Vision for Change indicates the recommended team size for adults is 23, for a child it is 13 and for the elderly it is 12. The witnesses mentioned their teams so do they reflect those figures? Assuming that is the case, the deficiency in the adult section is 25%, in the child section it is 46% and in the elderly section it is 40%. The staff numbers are smaller than they should be in all three areas. If we got the staffing numbers to the level prescribed by A Vision for Change, would we address, by and large, deficiencies that currently exist in our mental health services in CHO area 4?

The document refers to community and mental health staffing levels. I note that in some areas it is greater than what is needed but in other areas it is less than what is required. Killarney, for example, has 1.3 times the staff needed. Why are these not rearranged so there is no surplus in any area and deficits could be reduced? I would like an explanation as to why that is the case and what can be done to address it. There is also the matter of recruitment. Is the national recruitment service of the HSE responsible for all recruitment? Is that how it operates? I am speaking personally but I do not see how the recruitment process is visible. Are we advertising at recruitment fairs, for example, or what way are we going about this? Do we go to London and other international destinations to try to get people back here? There were several attempts by the National Health Service in the UK to target people, offering our graduates extra training to get them over there. We need to do something similar. If we are doing it, I am not aware of it. We would like to see more of it.

There is the matter of integration of primary care, specialist mental health services and the various organisations that work in this area. Are the witnesses satisfied that such integration exists and if they are not, what do we need to do to improve it? There are a number of organisations dealing with suicide prevention and mental health services in general. I am not convinced the work they do is linked with specialist mental health services, nor am I convinced that specialist mental health services are linked with primary care. As a committee, we must focus on this to help medical professionals achieve better results.

Somebody might present to me at the weekend if I get a phone call on a Saturday or Sunday night. We are elected representatives and often people see us as the first point of call. Is there an emergency number I can use to say I have a specific acute case that requires immediate assistance? This is so I do not have to tell somebody to come back to me on Monday morning. That could often be a crucial 24 or 48 hours.

Unfortunately, there was an incident in my home town last year, around September, which ended very tragically. I would have liked to have had services whereby I could have asked the person to contact a certain person who might have been able to help him or her. I did not, and that may be as much my fault as anyone else's.

Are the suicide crisis assessment nurses, or SCANs, as they are known, operational everywhere? If so, what is the link between the SCAN and the primary care services, and how do we get the message out there that this person exists in the community and his or her services are available? I am sure those services are much needed.

I refer to the issue of dual diagnosis, whereby people present not only with mental health difficulties, but also with addiction difficulties. I have come across situations whereby people are told that if they have an addiction, until they are clean they will not be seen. It does not work that way. A person with addiction difficulties and who has mental health issues needs immediate care. Trying to get him or her clean might be the very basic action needed and might set him or her on the road to recovery. I would be interested in Mr. Reaney's comments on that matter.

I note the suicide rate in Kerry is now 17 per year. Is this below or above the national average? What is being done in Cork and Kerry to try to get that down to the national average? I would prefer if there were no suicides at all, but they are a reality.

The last question I have concerns issues surrounding counsellors. There are many counsellors, or people purporting to be counsellors, but what level of qualification do the community health care organisations look for? Are jobs available for people with honours degrees in counselling services, a level 9 or level 8 qualification, particularly in hospital or community? If so, how do I direct someone looking for employment and looking to offer their services to the system?