James Browne (Wexford, Fianna Fail) | Oireachtas source

I welcome the allocation of additional funding for health care. However, it is only necessary as a result of the lack of credibility in the previous Estimates which had no real honesty.

My concern and focus is on mental health. I welcome the return of the €12 million funding to mental health services. I know it was hard fought for but the availability of it is only the first step. We must ensure this money is well spent and targeted. Going on past HSE figures, people have a trust issue as to whether this money will be spent. It is critical this money is distributed and is spent on mental health with further spending next year.

People with psychiatric illnesses do not have access to community-based interventions or support, ten years after the launch of A Vision for Change. The full implementation of the policy is part of the agreement between Fianna Fáil and Fine Gael to support a minority Government. We will be watching closely to ensure the money is spent to fully implement A Vision for Change. We must also review A Vision for Change and see where we are going over the next ten years in mental health service provision to ensure it is kept as a priority. We need 24/7 access to mental health services, particularly in our community and primary care centres for recovery-led mental health care. As well as 24/7 community health care teams, we need a proper plan for the attraction and retention of mental health staff. Last week, psychiatric nurses threatened to go on strike not just about pay but the conditions under which they must work. They are short-staffed and under pressure, seeing those looking for help cannot get the supports they need. We need a clear plan for keeping nurses and psychiatrists, including career pathways for them.

Emergency departments are not appropriate places for people suffering acute mental health episodes. They need to get support in the community. If one is suffering from a serious mental health situation, going to an emergency department is stressful enough. Many of these departments do not have psychiatric nurses and those that do, have them only from nine to five, Monday to Friday. We know psychiatric episodes are worse at night times and at weekends when people are alone or have taken alcohol and so forth, which may exacerbate the situation.

If one goes to the emergency department in Wexford hospital after 5 o'clock, one will be seen by a triage nurse after four or five hours. This nurse will have basic training in mental health and he or she will do his or her best. The triage nurse will telephone a psychiatrist at Waterford hospital who will make an assessment over the phone. If the psychiatrist deems further assessment necessary, the patient will be told to make his or her way to the Waterford emergency department, where one could wait another four or five hours. We know there is a significant level of walkouts from our emergency departments, particularly from people suffering from psychiatric episodes. It is understandable. If they are under stress, the last place they need to be sitting for five hours is in an emergency department. If a patient is deemed not to be a priority by Waterford hospital, he or she will be told to make their way home. This is not acceptable. We need to ensure there are supports in place for people with psychiatric issues.

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