Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the Chairman and Deputy Durkan for his contribution. I accept the point he made about projections and building in a bit of overhead room for contingency planning. It is a very reasonable and valid point. It could probably be calculated to a degree actuarially because it is a demand-led service. Increasing numbers of people are attending accident and emergency departments and so on. I could speak at length about the changing goalposts. What the Deputy said is that there should perhaps be a contingency fund, which is a valid and sound point, rather than having a debate every year about overruns. We will focus relentlessly on that overrun and that has been the priority for the Government and the HSE for the year, with some degree of success. Others may have different views on that.

The Deputy's substantive point was on mental health, an area very close to my heart and for which I have responsibility. I am quite happy to engage with him on that. It is difficult to comment on an individual case for obvious reasons and I do not know the background to the case to which he referred.

On the overall issue of accommodation for young people in mental health units in the country, only three counties in Ireland have inpatient beds for young people, namely, Dublin, Cork and Galway. These figures have not been verified, but this year there were in the region of 300 admissions to inpatient units for young people and teenagers.

I visited Linn Dara in Dublin recently. What it is doing is particularly impressive. It has developed a high dependency unit which is working well. It is also dealing with eating disorders in young people, which are very difficult and challenging for the system because there are young people in acute hospital beds who are medically unwell while also being mentally unwell. Linn Dara is treating such patients very successfully. It has had in the region of 110 admissions this year, which is a significant increase on last year. It has also had a significant increase in the number of discharges, which is very important.

The Deputy also referred to young people in adult settings. The numbers have reduced significantly this year, which I am glad to see, in particular in the second half of the year. This is due to the very good work being done by Linn Dara, which has reduced the reliance on young people being admitted to adult wards. There will also be a certain cohort of young people admitted to those wards, because of geography and the fact that parents may make a choice that they do not want to go to Dublin, Cork or Galway. As I have said, a 17 year old may be very strong and, therefore, be better off in an adult ward, rather than a ward for young people, even though the arbitrary age for such a ward is 18 years. We acknowledge that there are situations where there is no capacity, but they are reducing in frequency thanks to the good work of Linn Dara.

Deputy Durkan asked about the consideration given in the preparation of Estimates to mental health for young people, in particular. There are 70 community CAMHS teams and last year we created a lower level of infrastructure, namely psychology services, in the community. There are now 130 psychologists and assistant psychologists specifically for young people and a phone line was developed, which was launched last week, to direct people to the appropriate services available.

When we started our research, we found almost 1,100 mental health services were being funded by the HSE. However, people are not being appropriately referred, and either do not know where services are located or cannot find them. People are not always in a position to go to a GP, for financial or time reasons, to find out where to access services. The phone line is a significant development in terms of creating a more appropriate referral pathway.

The waiting lists for the 70 community CAMHS teams was 2,500 in January, but had reduced to 2,000 by October, a reduction of 20%. I hope there will be a 25% reduction by year end. That is a direct result of the introduction of psychologist and assistant psychologist services at community level the length and breadth of the country. The better way forward is early intervention and allowing people to access services sooner because there can be continual escalation of issues if people's mental health is not treated in a timely manner. I hope the change to waiting lists for community CAMHS teams for young people is sustainable. As Deputy Durkan knows, our ambition is to treat people in the community and give them the best services there. In the 1960s, there were 20,000 inpatient psychiatric beds in Ireland, but today there are just over 1,000. We have moved significantly away from inpatient beds, but there will always be a cohort of people who will require inpatient treatment. Portrane is being developed and will open in the coming year - the keys will be handed over in the next month or two. The number of beds in the Central Mental Hospital will increase from 120 to 170, a number of which are for young people. We will have increased capacity for CAMHS patients and teenagers. Mental health is very much a consideration in our budgetary planning for the year ahead.