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

I thank the Deputy for raising these issues. The policy of the HSE, as reflected in its annual service plan, is that young people under the age of 18 years should receive age-appropriate treatment and, when necessary, be placed in age-appropriate settings. That does not happen 100% of the time but achieving that is the goal.

Child and adolescent mental health services, CAMHS, have been prioritised in the new funding that has been made available since 2012. In terms of additional resources it means we now have 67 CAMHS teams. I do not claim these teams are operating at 100% capacity because we know they are not. We have three paediatric liaison teams and there are 66 operational CAMHS beds nationally. While 66 beds are operational, there are 76 beds in total but there is a difficulty with the recruitment of staff. Until we hire the staff we cannot open the full number of beds. The Deputy referred to the 20 beds that were promised in Limerick. As far as I am aware, this dates back to the term of the former Minister of State, former Deputy Tim O'Malley. There was discussion at the time about opening a new unit in Limerick. However, if one adds the 76 beds, anticipating that we fill the staffing needs, with the new beds that will be available in the new Central Mental Hospital, that will bring the total to the amount that was recommended in A Vision for Change. Obviously, a review of A Vision for Change is taking place at present, including of the figures. As the Deputy said, the number of people referred in the Limerick area alone has increased by 15% and the increase in the number of children coming into the system this year is approximately 8,500, so the figures must be revisited. I am not sure if Limerick might come back into the frame at that stage.

It is important to stress that a lack of funding for mental health services is not the problem. The Deputy correctly pointed to the difficulties with the recruitment of staff. As regards the two staff members who were sick, the difficulty is that it was extended leave so one does not know when they will return. Replacement for maternity leave is a problem across the board and particularly in mental health services, where a huge number of nurses are young women. The fact that we cannot replace any maternity leave is something we are trying to work on outside the Department of Health as well. In the case of new staff, replacements have been approved but the services have been unable to fill the posts. There is a huge difficulty with recruitment and retention of staff and it has nothing to do with funding.

The new standard operating procedure introduced in June 2015 has provided greater clarity and consistency in how the specialist mental health service for children is delivered nationally. A huge amount of work is being delivered by the HSE, which is trying to ensure that younger people stay away from the CAMHS. CAMHS should be specifically for young people under the age of 18 years who have severe mental health problems. There are self-harm nurses in all the level 4 hospitals. They not only work with young people but also train people within the hospital on how to deal with young people when they come to the hospital. We have developed new eating disorder hubs and the dual diagnosis clinical programme, for young people who present with alcohol and drug related issues which are affecting their mental health as well. There is also the development of the new transgender programme, which at present is focused on people over 18 years of age. However, there will be a new programme for young people as well.

The HSE service plan for 2017 provides for further development of the CAMHS, including better out-of-hours liaison and seven-day response cover against a background where we expect an increase of 8,500 young people this year. Approximately 18,500 children will attend CAMHS this year, including approximately 14,000 referrals. All of this information is available on the HSE website. With regard to community health care organisation, CHO, 3, which includes Limerick, consultant-led community-based services are provided by six multi-disciplinary teams in Limerick city and county, Clare and north Tipperary. To answer the Deputy's question regarding children under 18 years, the reason there are no services for 17 year olds in north Tipperary is that this requires a clinician or consultant post and the HSE has been unable to fill that post.

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