Oireachtas Joint and Select Committees

Wednesday, 11 July 2018

Joint Oireachtas Committee on Future of Mental Health Care

Engagement with Minister for Health and Minister of State at the Department of Health

1:30 pm

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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There is an awful lot there and I am going to have to be very brief as I have to be gone in about ten minutes and will go through them as fast as I can.

I have addressed the issue of Linn Dara already this morning, which is an issue of realignment of services. Due to staffing challenges it will start in the summer time. There is a maximum of three people impacted by this. I have looked into the three cases. They are all being provided with alternative supports and services under CAMHS, not just under that particular model of day services. The have been referred to the community teams. I do not want to go into details where the numbers are so small it can be very easy to identify people, but I have assured myself of what is going on there. Other than that I cannot go into any more details on that. I do not have any further questions from Senator Devine.

Deputy James Browne is not here so I can come back to him on some of his questions.

The question of teenagers in adult units is a debate we have had before and the Chair herself has shone a light on this. The issues there are not black and white for legislation, but they are to be dealt with and the senior Minister referred to it as well.

The two representatives of Youth Work Ireland Galway services are welcome to the meeting here today. I went to visit them last year, on the invitation of Deputy Rabbitte and her colleagues. I am disappointed to see that things have not moved on since that time but I will ask to have that file reviewed by the HSE and sent down to my office and I will go through it and come back to the Deputy and her colleagues directly on the issues affecting them there.

Senator McFadden asked where the money is being spent. A 6% debate is something I would like to address; I believe it is 6% but I never know what figure people put on it. I believe it is a bogus argument to be talking about the percentage of moneys spent on mental health. In the first instance if I was measuring the amount of money I was spending on mental health I would never use the yardstick of physical health as a comparison, which is dysfunctional in itself, is bogus and is not real.

Furthermore, we spend significant amounts of money in the whole area of mental health, for example on primary care. All of the mental health services are delivered through primary care, are budgeted under primary care, not under mental health, so they do not come out of my €910 million budget, it comes out of the budget for primary care, even though it is delivered to mental health. NEPS services come out of the Department of Education and Skills budget, and those are mental health services.

There are many health services in the justice system. I am not defending the amount of money we spend on the area but that particular argument, and comparing Ireland with other countries when our budget is only 6%, is so flawed it is unhelpful and does not represent anything.

I will make a few points on the range of services. The signposting, the phone line, has been my ambition since taking office. It is referred to as a help line and various other things. Essentially, it is a single access point for all mental health services. That will address Senator McFadden's concerns about the range of services available. We have finally completed a directory of all the services and if there is one number that people can call, they can be appropriately referred. A member asked if the people at the other end of the phone line will be qualified. They will be qualified. They will not diagnose but will refer callers to the appropriate services. That is lacking in the system. As the senior Minister stated, we often come across cases where people are not aware of the services.

There is a tendency for all young people to be referred to the child and adolescent mental health services, CAMHS, but there is no need for all young people who have mental health challenges to be referred to a psychiatric service. That national front door element will go a long way to streamlining many of the services, which in itself will be constructive in dealing with the CAMHS waiting lists because many of those who are left on the waiting list require lower level intervention. They are left on those waiting lists because a psychiatrist has stated that they do not need to see a consultant psychiatrist but he or she is not aware of where they can be referred. If we can streamline that, that will be the best way to address the queues. If we introduce a waiting list initiative, however, we are just addressing the symptom and not the root cause of the issue.

Deputy Buckley commented on a five year plan from the Health Service Executive, HSE.

There was a question on inpatient beds. We will have increased capacity in Portrane. We have already acknowledged that community healthcare organisation, CHO, 5 has a shortfall. We hope to examine that.

Talk therapies will be part of telepsychology, telepsychiatry and teletherapies. It is just a way of delivering those services in a more efficient way rather than having people make an hour or three hour return journey for a 20 minute therapy session. There is a good deal of help in that regard.

The senior Minister has addressed many of the other questions. Deputy Brassil-----