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

Yes. I am sharing with Deputy Neville.

This is the third debate we have had on mental health in recent times. I welcome the debate as an opportunity to re-state the Government's commitment to our mental health policy and to the development and improvement of our mental health services.

The Government will not oppose the motion. We agree on the need to maintain the significant progress in this area. We have already given an undertaking in A Programme for a Partnership Government to increase the mental health budget annually to build capacity in existing services as well as developing new services.

Since 2012 an extra €115 million and approximately 1,150 new posts have been allocated for mental health suicide prevention initiatives. This happened during tough economic times for this country and at a time when every other Department had its funding cut. By the end of this year, funding for mental health will increase from the 2015 out-turn of €785 million to a projected budget of €826 million. This includes the return of €12 million, something myself and my colleagues fought hard for this year.

In addition, budget 2017 has provided for additional spending for enhanced services of €35 million on a full-year basis to enable further improvements in a range of areas. The key priorities to be addressed for me in the HSE service plan include youth mental health, further improvements to child and adolescent and adult services as well as older people services and further enhancement of out-of-hours responses for those in need of urgent services. These developments will be outlined in the HSE service plan in the coming days and weeks.

We recognise the time-lag involved in new staff taking up posts and the completion of preparations for the introduction of these services. It is estimated that the revenue spend in 2017 associated with the increased allocation will be some €15 million. There will also be a further additional spend of €9.7 million in mental health associated with increased pay costs. This increase in wages will, I believe, go a long way towards realising the full implementation of A Vision for Change in the coming years. The additional allocation of €24.7 million for 2017 will see the mental health budget increase to €851 million. This represents an increase of 3% over 2016 and a 20% increase in the mental health funding since 2012.

In addition, the Government has given the go-ahead for the construction of a new national forensic hospital at Portrane. I encourage my colleagues to visit the Central Mental Hospital to meet the staff, patients and their families. In this way, Deputies would understand why this major health infrastructure project is needed. Furthermore, Deputies would see how some of the most vulnerable people in our society will benefit from significant capital investment in 2017, when spending on this new hospital and other minor initiatives will total in excess of €50 million. Deputies have referred to one-off projects. This is possibly one of the largest one-off projects we will invest in and it is certainly worthwhile.

I am very much focused on modernising our mental health services in line with A Vision for Change. That is why overall spend next year on mental health will be over €900 million. In addition to the substantial ongoing funding commitment to service development, I have started the progress of updating our current mental health policy, A Vision for Change. I have commissioned an evidence-based expert review which will focus on the progress made to date in implementing the policy, including a review of current delivery of services in Ireland. The review will also take account of current international best practice and will inform the next steps in the development of a mental health policy, having regard to human rights and health and well-being objectives. The review will provide a solid evidence base to determine the policy direction of a revised A Vision for Change. It will provide a basis for further service development in this area and shape our future mental health policy. This is important work.

In line with the commitment given to Dáil Éireann on 6 October this year, an oversight committee will be established within three months of the review being finalised to oversee the development of a new policy for mental health based on the outcome of this review. The successor policy to A Vision for Change will include a multi-annual implementation plan to inform the allocation of resources in future years. As per the commitment to Dáil Éireann the HSE will be directed to develop a multi-annual approach to the development of mental health services.

Implementation of A Vision for Change has been affected by a number of factors since 2006, including the economic collapse and the troika. Deputies have spoken of insufficient funds. These factors resulted in no increase in funding from previous Fianna Fáil Governments. Public spending constraints and the moratorium on recruitment have affected the sector as well. However, recent years have seen investment in this areas prioritised by Fine Gael led Governments and significant advances made in the reconfiguration and delivery of services.

Although I agree that it is not enough, the increased investment in mental health services in recent years has helped to increase the number and staffing levels of adult and children and adolescent community mental health teams. Of the additional 1,550 new mental health posts approved since 2012, a total of 1,150 have been or are in the process of being recruited, notwithstanding the general challenging recruitment market in which the HSE is operating.

We must continue to invest in our mental health teams. Those working at the front-line carry out important work and we must support them. I intend to continue in this regard. Earlier this summer, I allocated €400,000 to provide 60 additional training places for psychiatric nurses. The number will increase to 70 next year. In the coming four years we will increase the number of training places by 45%. Since the summer psychiatric nurses have seen the re-instatement of their community fund and of some of their wages. I imagine Deputies will agree that we are doing our best to try to ensure we can plan for our future.

Increased investment has also funded the development of specialised services recommended in A Vision for Change, including forensic, eating disorders, psychiatry of later life and mental health intellectual disability services. We are also seeing continued development of community mental health teams as well as improved seven-day responses, liaison services, perinatal mental health care and two new clinical programmes specifically for ADHD in adults and children and dual diagnosis of those with mental health and substance misuse.

I agree with all Deputies who have spoken already in the sense that I agree there are difficulties within the service and we do not always get it right. The aim is to try to continue to improve the services. This year we are also advancing the development of counselling services at primary care level. We are providing considerable extra funding to extend services such as jigsaw, which offers free access in a more informal environment to younger people.

A Programme for a Partnership Government recognises the need to promote awareness and prevention strategies further in our education system. This is why I have established a task force on youth mental health. The task force has met on three occasions thus far. At the most recent meeting, the task force met younger people, family members and service providers to discuss the difficulties they are facing. This week, our first youth engagement panel will meet. The panel is for people between the ages of 19 and 25 years.

We have already identified key areas which we wish to progress, and I look forward to updating my colleagues more on this in the coming weeks.

I think we will all agree that the mental health needs of this country have somewhat changed. The review of the implementation of A Vision for Change will help to monitor this, but the need to plan could not be clearer. I acknowledge those in the Gallery this evening and those who are listening to this debate. There is a momentum behind this. We are all behind this, but if anybody is unsure in that regard, let me be very be clear: as Minister of State with responsibility for mental health, I and this Government are 100% committed to implementing A Vision for Change. We are 100% committed to supporting our younger people. We are 100% committed to planning for the future because lives will be lost if we do not do so. Lives have already been lost. I welcome the very open and positive discussion tonight and I thank Deputy Browne for tabling this motion.

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