Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

Addressing the generally accepted historic deficiencies in both the capital and non-capital aspects of our mental health services remains a priority for the Government. This is reflected in the fact that we are following through on our programme for Government commitments, with some €70 million provided this year and last year for a range of new posts and other specific initiatives relating to mental health and suicide prevention.

Notwithstanding progress on addressing the overall financial pressures still facing the country and the demands being placed on all areas of the care system, the HSE mental health budget increased this year, from approximately €711 million in 2012 to €733 million in 2013. The HSE service plan for this year indicates that the Galway-Roscommon local health office will receive approximately €69 million for mental health services in 2013.

The Deputy will appreciate that the HSE has statutory and operational responsibility for the planning and delivery of services at local level, including for the Roscommon area. It should be noted that the per capitaspend on mental health services across Galway-Roscommon is the second highest in HSE West, at €220 per head of population, and is significantly above the national average spend of €160 per head. In short, there are significant resources in Galway and Roscommon mental health services, but there is also a need to review the current configuration of services. Both community and inpatient services are provided in Roscommon and are deemed to be the one entity in the context of the Galway-Roscommon local health office area.

Replacing the Central Mental Hospital, CMH, with an appropriate modern facility is one of the priority health projects set out in Infrastructure and Capital Investment 2012-2016: Medium Term Exchequer Framework. The Minister for Health announced in November 2011 that the CMH would be located at St. Ita's, Portrane, County Dublin. This project includes replacement of the CMH and also development of associated new facilities. Four regional intensive care rehabilitation units, ICRUs, are also planned, one of which will be located at Portrane. The further three ICRUs will be located in Cork, Galway and Mullingar.

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A steering group for this project is in place and members include representatives from the Department of Health, the HSE, the Central Mental Hospital, the National Development Finance Agency and representatives from appropriate non-statutory stakeholder groups. The design team appointed in July 2012 is advancing the design for the project and this work is progressing satisfactorily. The most up-to-date position on reconfiguration of the national forensic mental health service facilities is contained in the current HSE capital programme.

On the wider implications raised in the question, implementation of A Vision for Change, the report of the expert group on mental health policy in 2006, and the reform of mental health services are a priority for the Government. Although implementation of A Vision for Change has been somewhat slower than expected, a great deal of progress has been made with the accelerated closure of old psychiatric hospitals and their replacement with bespoke new facilities, better suited to modern mental health care. Progress also includes shorter episodes of inpatient care and the involvement of service users in all aspects of mental health policy, service planning and delivery. There has been a considerable decline in the number of patients resident in psychiatric facilities, with numbers falling from 10,621 in 1987, to 2,812 in March 2010, representing a reduction of 73%.

A modern mental health service is best delivered in the community and in this regard the Government has provided an additional €70 million and almost 900 additional posts in the past two budgets, primarily to further strengthen community mental health teams in both adult and children's mental health services, to develop forensic services, to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care specifically for people with mental health problems, and to facilitate the relocation of mental health service users from institutional care to more independent living arrangements in their communities, in line with A Vision for Change. It is expected that the appointment by the HSE of a new director for mental health in the near future will greatly accelerate the pace of implementation.

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