James Browne (Wexford, Fianna Fail) | Oireachtas source

There are no staff to care for children who suffer from disabilities such as autism or Down's syndrome and who also suffer from a mental health illness in three health areas, CHO 1, CHO 3 and CHO 6. These children with disabilities are four times more likely to suffer a mental health issue and are least able to cope when they receive the worst mental health care services of any mental health service. Meanwhile, the number of children admitted to adult units was 68 three years ago but was 84 last year. The number is clearly going in the wrong direction.

I wish to refer to consultants not on the specialist register but who practise as psychiatric consultants. The appointment of junior doctors who are not on the specialist register as consultant psychiatrists has rightly been condemned as scandalous by the President of the High Court. It clearly unsafe and may even put lives at risk. The Mental Health Commission confirmed yesterday that it will not allow such consultants to sit on mental health tribunals. Some patients have had their involuntary detention orders overturned because they were signed off by unqualified consultants. That is a scandal.

Only 1% of all mental health services in Ireland are regulated. I am concerned about the potential for serious risk to arise in some such facilities which ought to be regulated. Given the breaches of regulation highlighted in reports by the inspector of the Mental Health Commission into regulated facilities, one must worry about what is happening in the unregulated facilities. Similar facilities for disability care and physical health are regulated by the Health Information and Quality Authority but not those for mental health.

The abolition of the role of director of mental health in the HSE has been decried by all in the mental health community. That was a backward step. The Mental Health Commission stated that as the highest level of our mental health services workforce, it is both noteworthy and disappointing that the HSE removed the post of national director for mental health. The removal of this core leadership position sent out a clear and unambiguous, although perhaps unintended, message that mental health is not a priority. It is also evident to the commission that this has negatively impacted on the delivery of services nationally. That action must be reversed because it is clearly having a very detrimental impact on mental health services.

We are now 13 years into the ten-year national mental health strategy, A Vision for Change, yet the update to it has still not been published. The independent review group published its proposals for updates to the Mental Health Act 2001 in 2013 and we still have not seen the heads of a Bill. In 2013, the independent group charged with monitoring progress and implementation of our national mental health policy was disbanded and has not been re-established. There is much work to be done in areas of mental health policy reform.

I refer to the situation that arose in St. Luke's in Kilkenny. This year, our mental health services had to suffer the ignominy of its first ever prosecution in the courts. St. Luke's in Kilkenny was prosecuted because of the lack of care for some of our most vulnerable people. No mental health facility should ever be allowed to fall so low that it needs to be prosecuted. There is clearly a lot to be done in order that people across the country have fair and equal access to mental health services. The key points I have highlighted reflect only some of the many issues I could have highlighted if I had sufficient time. I hope we will have time to discuss them in the future.

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