Dr. Shari McDaid:

He referred to telepsychiatry. We asked Mr. Kevin Cullen of the WRC to prepare an analysis of the various options on e-mental health. We can send that report to the committee. It shows a strong evidence base for telepsychiatry.

It is one of the oldest, longest-established digital or e-mental health initiatives. It is quite well established, particularly in the United States where they have had to cope with remote areas and providing for specific scenarios.

With regard to the Mental Health Commission not closing services down even when they do not comply, I do not know why that is, but I know it seems to be different from the approach the Health Information and Quality Authority, HIQA, takes. It is hard to make sense of not closing services down in light of the fact that the lack of compliance is around basic regulations and minimum standards. Services which are failing minimum standards are allowed to continue to operate. That has to be looked at. If that means stronger powers need to be granted from the commission, or stronger usage of those powers, that needs to be explored and dealt with. We have seen deterioration. We have not necessarily seen a straight improvement in services, even in things that do not cost money, such as care planning, where services might be okay one year but the next year might fail to comply, and the next year the same service might still not comply even though it had been a condition in the previous year. We do not get the impact from that regulation that we need so that people can have confidence in the services they use.

I was asked what the top three wins would be. The third one that came to mind is about increasing access to supports in the prison system. There is a huge need there which costs us greatly.

We have talked about investment in mental health, and the relationship between this group and the oversight group. One recommendation this group could make, even on an interim basis, that would be helpful is to ensure there is a costing of whatever comes out of the departmental review of A Vision for Change. It is not obvious from the terms of reference of the departmental review of A Vision for Change that there will be a costing of what it will take to implement it. Without that costing, we are concerned it would be less likely to be implemented. If this committee could recommend that a costing is done, that would be great.