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

I thank the Members from various parties for their contributions, my officials to my right and the civil servants in the Department who have helped prepare for this and studiously taken note of the contributions that have been made. Rumours of my demise have been greatly exaggerated. On a more serious note, nobody has a monopoly on wisdom regarding the right thing to do in respect of mental health. We all acknowledge that we have come a long way in our recognition of this issue and in our ability to destigmatise and speak more freely about it and the challenges to which it gives rise.

CAMHS is a specialist service within the mental health services. A multitude of other services are available in the context of mental health but CAMHS relates to young people and attracts much attention. As stated earlier, I met the CHO and clinical leads in the nine CHOs in the last ten days. I informed them that I would not run a waiting list initiative and that I would much prefer to deal with the structural challenges that exist within the area of mental health. We have made significant progress in respect of those challenges. I am of the view that meeting them is the key to the future. It would be worth Deputies' time informing themselves and becoming more aware of the changes that are happening. I held a briefing in the audiovisual room in November. I am of the view that it was a helpful exercise; it certainly was for me. It allowed the Members in attendance to question some departmental and HSE officials and get more accurate information. A contribution was made here today which spoke about telepsychiatry and telepsychology as speaking to a robot on a screen. That level of ignorance is not helpful and people should make an effort before commenting on specific initiatives to at least inform themselves. That is not universal but a very isolated incident. I think most people take more care to research what they are talking about.

We have three specific proposals that I hope to advance in the coming year. One relates to telepsychiatry and telepsychology. The latter do not constitute a silver bullet but they offer alternatives to address the recruitment issue because we cannot keep saying we have a recruitment problem. We have to look at new ways of delivering mental health care. The mental health telephone line training will begin on 7 February for the National Ambulance Service. We will have a 24-hour, seven-days-a-week telephone line that will be manned by professionally qualified mental health staff. There is already demand for that with up to 800 calls a month going to the National Ambulance Service which are related to mental health which it does not have expertise to deal with and where sending ambulance is not the answer except in a tiny minority of cases. We will have appropriately trained people taking those calls 24 hours a day and referring people to services. Some 1,027 different mental health services are funded by the HSE but many people do not know where they are or how to access them.

The other fundamental thing we are doing is building a further level of infrastructure underneath CAMHS. We made significant progress on that last year when we hired 114 assistant psychologists and 20 psychologists. We need to continue to build on that.

Deputy Wallace made many interesting points about the over-medicalisation of mental health and the importance of psychotherapy and talking therapies being introduced along with early intervention and support in primary care. We are making significant progress on that to build that level underneath CAMHS. There is an over-reliance on CAMHS. Many people do not need to avail of CAMHS who are being referred to them. There are more appropriate options but, due to the lack of alternatives, people are referred to CAMHS. The key to successfully dealing with the CAMHS waiting lists is decreasing our reliance on it. We will open a crisis text line this year. International evidence has shown that this works well. Young people are much happier and more free to text and will be more likely to do that than to pick up the phone or approach a mental health professional. We have to ensure that we roll that out successfully and I believe we will do so. Those are some of the digital platforms, and we will also roll out cognitive behavioural therapy.

I do not have time to address all of the points relating to A Vision for Change, an extraordinarily ambitious document which was launched in 2006. We cannot forget what happened in the country after 2006 when the economy crashed and a great deal was lost. Much was achieved in the context of A Vision for Change over a ten-year period. If the Sláintecare report achieves anything like A Vision for Change achieved, we will have top-notch healthcare. I will be the first to admit that we have a long way to go. We do not want to have waiting lists. We want more people to reach out for the services and we do not want them to be discouraged by waiting lists. Structural reform is required. There is no quick fix or easy solution.

I thank Members for their contributions. I hope to facilitate another engagement in the audiovisual room in another month or two to which I will invite Members. We can have a further question-and-answer session at that point.. I thank the Ceann Comhairle for his leadership and facilitating this debate.

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