Dáil debates

Friday, 14 July 2017

Mental Health (Amendment) Bill 2017: Report and Final Stages

 

10:50 am

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank Deputy Browne for introducing this Bill. I wish the Minister of State all the best in his new role. Having worked with him in his capacity as Chairman of the Joint Committee on Children and Youth Affairs, I know where he comes from. He is visionary. When he puts his mind to something, he delivers on it. I expect the same regarding mental health. It is great to see Deputy Neville in the Chamber because he is also a member of the committee. The committee places great emphasis on children, youth and mental health. One of the first items on the committee's agenda for the autumn is mental health. This comes on the back of the Minister of State's view, expressed when he was Chairman, that the committee should focus on mental health, children and early intervention. It is opportune for us this morning to focus the Minister of State's mind on what the committee, my party and I would like as we enter the recess in light of our position in the supply and confidence agreement. We request support across all parties and none in securing early intervention, which is essential for children. If we spend on early intervention, we will make savings a long way into the future.

CAMHS is at crisis point, as the Minster of State knows. Everybody has alluded to staffing. Up to last April, 84 CAMHS posts were still not filled nationwide. I compliment the Galway CAMHS team because it is doing so well in recruiting. One must ask oneself, however, whether there are gatekeepers in the HSE who simply are not letting the people in. People are actually applying for the jobs. I know that myself. It is okay being a gatekeeper but not at the expense of young people or anybody's life. We need the staff working in the industry. We are receiving some of the best curricula vitae but we are not recruiting.

We are advertising. We are doing all we should be doing but we are not putting bums on seats or putting people in front of patients to look after them. One of my suggestions relates to GP care. We have a GP intervention system for adults but we do not have one for children. GPs are the clinicians and they are on the front line. Parents do their very best and it takes a lot for a mother or father to come to the point of presenting at a GP surgery when his or her son or daughter is in crisis. If the clinician identifies that an immediate intervention is required, I need to know there is a dedicated phone line so parents can contact the local CAMHS team directly and get an on-the-spot referral. I am not talking about an accident and emergency intervention or writing a letter of referral to CAMHS. There has to be a mechanism to get somebody straight on the road to intervention.

I am also talking about 24-hour crisis support. There has to be an on-call support service for GPs and it cannot be just the accident and emergency route. When I talk about crisis intervention, there are 45 beds in Galway outside of CAMHS. There are eight CAMHS beds and 45 in the hospital. Referring a child to accident and emergency to put them in an adult ward is not the way we should be doing business. The Minister of State and I both know it is not. We need to ensure that GPs are supported so they can make the correct interventions and have the right signposts to get the right support for families. It is crucial work which every GP in the country would welcome. It goes back to the plan for supporting communities. It would support families. When we talk about children and early intervention, CAMHS is dealing with crisis cases. Every case that comes before CAMHS involves a crisis. Yet there are 2,400 children waiting to get to be seen by CAMHS. The figures are startling. The Minister of State has the budget. Hopefully, this year we will see that €35 million budget. If the Minister of State cannot spend the budget within the realms of the HSE because of staffing and recruitment issues and how long it takes to resolve such issues, let us work with the advocacy groups because they are best positioned. Many advocacy groups have trained clinicians working with them for them and they have good teams.

Deputy Cahill referred to Jigsaw in Tipperary. Jigsaw also operates in Galway and I can tell the Minister of State about the wonderful work it is doing. It is doing outreach work because we are trying to open an outreach unit in Gort in south Galway. Jigsaw has the base and it knows how matters work. People voluntarily walk into Jigsaw offices.

I wish to talk about the youth work counselling service in Galway. The Minister of State was very good to us. In the past week, he has shown his leadership in the area of mental health. He heard us debate the issue here during Topical Issues. Within a week we were in front of the HSE and by yesterday the email was back on our desk saying it will be supported. I will ask the Minister of State's Department to talk to the other Departments and to learn to engage with the Department of Children and Youth Affairs and the HSE. They should all work together because the joined-up thinking is missing. The Minister of State and the Minister, Deputy Zappone, understand the point of such thinking. Perhaps we need to get that understanding further down the ranks within the Departments and among the officials in order to break down the bureaucracy. We have to start working together. The Youth Work Ireland project in Galway was on its final lap until the issue was raised in the House. It was the Minister of State's intervention and that of the CEO of the HSE in Galway that pulled it out of the fire. I thank the Minister of State for that. I wish him well. Early intervention has a huge part to play.

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