Helen McEntee (Meath East, Fine Gael) | Oireachtas source

I thank Deputy Browne for his question. The Mental Health Commission is charged with visiting and inspecting every approved mental health centre at least once a year. The commission, as the Deputy has rightly pointed out, has now published its report on St. Luke's Hospital in Kilkenny, Cavan General Hospital, Naas General Hospital and Clonskeagh hospital.

While each premises received excellent and good rankings for elements of their performance, there were concerns about the upkeep of the premises, other issues and the admission of children to the St. Luke's Hospital adult psychiatric ward. A maintenance programme is in place in each of the relevant hospitals to ensure all issues identified in the report on the premises upkeep are addressed. The Government is strongly committed to improving all aspects of our mental health services and, as Minister of State, I am committed to this also. Funding for mental health will increase from the 2015 outturn of €785 million to a projected budget of €826 million in 2016, an increase of €41 million, or 5.2%, which includes €35 million ring-fenced for mental health for new developments.

The admittance of children to adult units is sometimes permitted for reasons of geographic location, the expected length of stay, which is usually short term, and the age of the young persons involved, which is usually between 16 and 18 years. It is seldom a person younger than that is admitted, however it happens. Nobody agrees with this policy, and we all want to ensure it does not happen.

The HSE National Service Plan 2016 aims to improve the placement of children in age-appropriate mental health settings. We have set a target of 95% appropriate placement, and this is indicated in the plan, to allow for some operational flexibility surrounding emergency placements in adult units. I will take on board the Deputy's point that this must be a top priority. While it remains challenging, progress has been significant, despite increased demands on the CAMHS service. In 2008, there were 247 such inappropriate admissions to adult units, whereas in 2015 there were 95. While that was 95 too many, we are moving in the right direction and must continue to do so. It is a priority for the HSE to keep such admissions to a minimum, and this must be kept under constant review. It is not appropriate that anyone under the age of 18 be in a situation in which they feel scared or threatened and we want to ensure it does not happen.

I will continue to prioritise development of all aspects of CAMHS, including timely access to appropriate services, early intervention and an integrated service approach, again bringing it back to the community. A comprehensive approach, sometimes involving services outside of CAMHS or the HSE, is required to further reduce such placements. The admission of a child or adolescent to an acute adult inpatient unit is made following a clinical assessment of the needs of the individual. Sometimes, even if beds are available, they may be at a distance, and other factors must be taken into account.

The HSE is actively managing the issue of the admission of children to adult units. Specific measures adopted include a dedicated notification system to inform the mental health division whenever a child is admitted to an adult unit so it is constantly monitored. This information permits direct engagement with the local management team to develop a timely clinical management response to ensure a child or young person in this position is assessed and, if required, sent to an appropriate CAMHS as soon as possible. The timeframes are generally small. Many of the 95 admissions are, unfortunately, accounted for by a child who has come back a second or third time.

Bearing in mind all the circumstances, the hospitals concerned are making progress on the issues raised, while taking account of the wishes of each young person, his or her parents or guardians, and the complexities of each case. The Department will continue to closely monitor the issues raised in the report, particularly regarding the admission of children to places where they should not be.

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