Mary Butler (Waterford, Fianna Fail) | Oireachtas source

Okay. One of the recommendations relates to out-of-hours crisis resolution teams, crisis cafés and the development of digital supports. I would like to speak a little about crisis cafés, or community cafés as I prefer to call them. I travelled to Galway recently to officially open a crisis café. It is located immediately across from University Hospital Galway. It is run by people with lived experience - peer workers. It would not be possible but for the generosity of the person who owns the café. At 6 p.m. in the evening when the café has finished its work, the owner hands it over to a community-led mental health team to support people presenting at the emergency department with ill mental health. A person can present to the emergency department and cross the road and sit down and meet with a peer worker there, someone with lived experience of mental health. People can stay there for however long it takes - two hours, three hours of four hours. In some instances that intervention might mean a person may not have to go to the emergency department at all, but it also means that he or she is getting the necessary support. The café opened earlier this year. In July alone, it had 78 presentations. Out-of-hours is the time people feel most vulnerable: in the evening after 8 p.m. or 9 p.m. or at weekends, when they do not have access to some supports to which they have otherwise have access during the week. This is a fantastic initiative that is supported by Mental Health Ireland. It is also supported by the HSE from a funding perspective. The funding element of it is very small, apart from the staff, because of the generosity of spirit of the person who owns the café to open up his premises and allow access to it for people with mental health challenges, mental illness or emotional distress. I was blown away by the generosity of spirit of this gentleman in giving up his café. I believe this system operates in America. I would love to see it being rolled out across the country. It is a fantastic initiative.

I compliment the various NGOs that partnered with the HSE and the Department to provide supports during the pandemic. Some €1.1 million extra was advanced to them to move online very quickly to enable the supports to remain open. We can never replace the face-to-face appointments which some people love. They like to sit down opposite a healthcare professional. In some instances, that was not possible during Covid, but we were able to retain supports at 85% to 90% during the pandemic by working online. Most young people embrace technology, as do more and more people in general. The blended approach is the way forward. We probably made more progress with digital supports in the past 16 months than we would have made in the next five to ten years. It is a small positive.

Recommendation 4 concerns increasing resources for specialist mental health services for young people, including Travellers. The national implementation and monitoring committee is in place and it has already set up some sub-committees to look at different areas. The three sub-committees that will be set up initially relate to CAMHS.

It will look at the age profile regarding when a young person should leave child and adolescent mental health supports. For example, supports for those attending Jigsaw are available for people aged between 12 and 25 but for those who might have been attending CAMHS for two or three years, and who got on very well with the clinical professional working with them, when they turn 18 they move on to the general adult mental health supports. This can be extremely traumatic for young people doing the leaving certificate, who may be going to college or who are leaving home for the very first time. Included in Sharing the Vision is a recommendation that we look at this to see what is the best age for people to exit the supports they receive from CAMHS. One of the sub-committees will look at CAMHS and whether the age will remain at 18 or whether it should be 21, 23 or 25. We are open to looking at everything. Another sub-committee will do a complete analysis of inpatient bed capacity throughout the country. At present, we have 2,496 beds. We also have 1,338 community beds in 110 facilities throughout communities. This bed capacity review will look at everything, including eating disorder beds and child and adolescent mental health services beds, to see where we are and to give us a real-time picture as to demand and capacity. Another committee we are setting up will look specifically at women's mental health. We will also establish committees on minority groups in the future.

The steering group that will oversee it all is in place. We will then set up offshoots of various committees at various times. A committee might last for six months or 12 months. It is not prescriptive and will depend on the amount of work a committee has to do at that particular time. A whole pool of people have volunteered. These include at least 50 professionals. We have people who have used the services. We have family involvement. Throughout the entire sector we have people who want to be involved and who want to make our mental health services the best they can possibly be.

I am enthused and I thank each and every one of the healthcare professionals who have worked in mental health over the past 16 to 18 months. It has been a very difficult time and I have to say they have coped very well with regard to Covid, particularly inpatient services. Thankfully, we were not too challenged with regard to the number of people we lost to Covid. I thank everybody across the board for their work on the ground, in the community and in the clinical programmes to maintain mental health supports at between 85% and 90% over the most difficult time. It really is an indicator of the great work that has been done. Something I have learned since I came into the post is that I was not aware of the huge amount of positive work that has been done in our communities by community teams and the key workers appointed to people. A phenomenal amount of work has been done. We want to build on this. We do not know what the next 24 months will bring and we have to be prepared to adapt very rapidly and to scale up wherever a need might be.