Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the Deputy for his question. A Vision for Change, published in 2006, set out a ten-year policy framework for Ireland's mental health services. It recommended that interventions should be aimed at maximising recovery from mental illness, building on service user and social network resources to achieve meaningful integration and participation in community life. As the Deputy will be well aware, one of the key principles of A Vision for Change was a fundamental move from institutional care to community-based care. The policy advocated for a move towards predominantly community-based care delivered by multidisciplinary teams. In line with this policy a number of old psychiatric hospitals has been closed due to the outdated nature of such facilities. However, the Department recognises that there will always be a need for acute beds. As such, there are currently 1,018 approved acute beds within the HSE.

Investment continues to take place to modernise this area of service and the HSE remains committed to improving rehabilitation services for people with severe and enduring mental illness and complex needs. This includes the new 170-bed national forensic mental hospital complex now under construction at Portrane, to replace the Central Mental Hospital, CMH, along with new facilities such as a forensic child and adolescent mental health service, CAMHS, unit and an intensive care rehabilitation unit, which will open in 2020. The HSE also intends to open an additional ten beds in the Central Mental Hospital as soon as possible once all necessary staff are put in place. New acute and high observation units have also opened in Cork and Drogheda in recent years, with an additional facility in Galway set to be operational in June 2018.

Many of those with severe mental illness and complex needs are discharged from acute inpatient units to a community residence, most often a high support hostel with 24-hour nursing staff available. Community residences provide a structure and support that this group of service users most often need after discharge. They offer an ideal place for further active rehabilitation for those who can acquire sufficient skills to become fully independent and live in their own accommodation. However, for some service users a more intensive inpatient rehabilitation service is required.

In January 2017 a national project was initiated which included developing a model of care for people with severe and enduring mental illness and complex needs. The model of care describes a specialist rehabilitation care pathway that ensures that the requirements of people with severe and enduring mental illness are met.

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