John Halligan (Waterford, Independent) | Oireachtas source

This legislation is long overdue and very necessary. The current situation allows for two consultant psychiatrists to authorise a course of ECT to a patient who has been admitted involuntarily for treatment, even if that person has capacity and refuses such treatment. That is absolutely in breach of international norms, not to mention an infringement of the patient's human rights.

I take this opportunity to raise an issue which is becoming an increasing problem for patients in psychiatric care in the south-east region, an area where the rights of mentally ill people to appropriate treatment are being infringed due to where the person happens to live. The amalgamation of the mental health services in Waterford and Wexford has been a disaster, and has had a disastrous impact on the level of services being provided to patients in the south east. The Waterford-Wexford mental health services, which serve a population of approximately 278,000, have spending in the mental health area of approximately €148 million. In Carlow-Kilkenny, the spend is €223 million while in south Tipperary it is €198 million.

Wexford now has no 24-hour mental health service and proposals for an acute mental health ward for Wexford General Hospital appear to have gone by the wayside. Mental health is not a 9 a.m. to 5 p.m. issue. When people are in crisis, they must be able to access the services at all times. Patients in Wexford are obliged to go to the accident and emergency department and wait for hours to be assessed. If it is decided they must be admitted, they are given a letter and sent to the accident and emergency department in Waterford. These are people who are distraught, and perhaps suicidal. That has been described by a doctor in Waterford as inhumane. A worker in the Waterford mental health services recently told me that should a loved one of theirs require mental health treatment, Waterford is the last place they would want that person to be sent.

Staffing shortages and inadequate facilities have resulted in a situation where severe mental health cases are being mixed with less acute cases, with adolescents being accommodated on the same wards. That is shockingly inappropriate. A total of 13 children from the Waterford-Wexford area were admitted to adult mental health services in 2014. The most recent 2015 data indicated that there were 12 such admissions of children to adult services. This is mainly because a bed was not available in the child services. I have encountered more than one horrifying case in which an individual presented at the department of psychiatry, DOP, in Waterford, was given a pill and sent away and then committed suicide. That has happened. There appears to be a complete lack of access to front-line assessment facilities in the community.

Furthermore, delays in accessing child and adolescent mental health services in Waterford are causing untold difficulties, particularly for children waiting for an autism diagnosis. Just months ago, I read, and had it confirmed, that the position of psychologist in the Waterford child services was advertised on JobBridge. That is unbelievable. There is currently no adolescent psychologist available in Waterford. Without a fully trained psychologist, children cannot be given the full diagnostic assessment for autism, which means they cannot access the service to advance in school. A new consultant psychiatrist was appointed to the service in October following a five month vacancy during which the region, with a population of 71,000 minors, had no psychiatrist available. We are still awaiting the appointment of a further two consultants, which have been promised for the Waterford unit. These staff shortages are having a detrimental effect on service provision.

Finally, last April, when a consultant with the child services resigned, there were 138 referrals on the books. A further 95 referrals were received between May and September 2015. The most recent data indicated there were 251 referrals, of which 136 were accepted. The rest are children and adolescents who are continuing to fall through the cracks in an overloaded system. Children and adults in the south east with various mental illnesses are not being given access to the full range of interventions they urgently require. While I support this Bill, I urge the Minister to address these issues in Waterford and Wexford without further delay.

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