Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Dáil again for the opportunity to conclude these statements and I thank everybody for their time and patience tonight. A huge amount of contributions have been made and they were all made in a positive vein, which I welcome. I will do my best to try to answer as many statements as possible if I can do so in the time allowed.

I thank Deputy Ward for his constructive approach and I look forward to working with him. We met yesterday and I would like to continue in that vein. He raised the matter of children in adult services and as I have said to him, that was one of the first matters I raised when I came into the Department. A reduction in the number of children admitted to adult psychiatric units is a priority for the HSE and it is a priority for me and for every Deputy in the House. It is fully accepted that admission to an age appropriate facility is in the best interests of the child. The HSE admitted 50 children into adult services last year. I have found out since that in a lot of those cases, they might have been males aged 16 or 17, whereas the CAMHS unit may not have been suitable for them at that particular time and they had to be housed in an adult facility for a while. On a couple of occasions, some of them might have entered such a facility on more than one occasion in the same year. I accept that a lot of good work has been done and the numbers have reduced but we have more work to do and I will continue to make sure that number comes down steadily. One child in an adult psychiatric ward is one too many for me.

Deputy Patricia Ryan mentioned Age Action, ALONE and the Community Call initiative and everyone here will compliment Age Action and ALONE and the fantastic work that was done.

I also wanted to mention Sharing the Vision and in that regard Deputy Connolly mentioned the national implementation monitoring committee. That is something that has been continuously worked on since I came into the Department. I will be different to other politicians and I am hoping to move this in the first week of October. It will be national mental health month in October and my aim is for us to put that committee in place. There will be an independent chair and there will be lots of sub-committees that encompass everything. It will not be top heavy at one end. The one aspect of Sharing the Vision that I love is that for the first time ever it is patient-focused and patient-centred and it is all about care in the community. The national implementation monitoring committee is hugely important. It will hold me, the Department, the HSE and everyone to account and will let us know very quickly whether we are doing the right thing or not. My aim is for the first week in October. That is my plan and that is what we are working towards at the moment. I am hoping nothing will change that.

I also wish to talk about the CAMHS waiting list, a subject which was raised frequently tonight. The waiting list stands at 2,366, which is a huge number of children waiting for supports. Deputy Ó Laoghaire mentioned that the numbers in the Cork and Kerry area are very high, which they are, at over 400. The numbers in Galway, however, are extremely good. I will start visiting all the CAMHS units and meeting the different teams across the country, but I accept that the numbers are too high. I have been working with the HSE to see how we can reduce them.

Not everybody likes the National Treatment Purchase Fund, NTPF, but for the first time ever we are going to look at using it for diagnostics. Legislation will be needed for this to happen because the current NTPF only deals with situations where people go into hospital to have hip or cataract operations, for example. We will need legislation to see how we can move forward with using the NTPF in the area of diagnostics and how we can buy diagnostics. We also want to ensure that there are no unintended consequences. When children come under the care of a CAMHS unit, they are being cared for in the community, and the most important thing is that that level of care in the community carries on. I am conscious of that, and I hope to move on that initiative soon as well.

Many Deputies mentioned day care centres. This matter is close to my heart. I am a strong advocate of day care centres. I met the relevant team in the Department of Health this afternoon to discuss this issue. I am very concerned about the effect that the continuing delay is having on older people. One Deputy, I think it was Deputy Gino Kenny, mentioned that his mother attends day care services. My mother is 83 years old - she is watching in tonight - and she also attends day care services. I know everybody is missing those centres. The HSE is continuing to assess the risks and benefits of reopening the day care centres. One of the main issues is that some day care centres have more space and capacity. Grants have been put in place, for example, in some situations, such as for community halls where people meet at different times. The grants are to support those initiatives by assisting with the installation of hot water in bathrooms, hand sanitisers and all the different supports needed. The problem, however, is transporting the patients, residents and service users to these facilities and that is where we are seeing the issue. I am strongly in favour of day care centres, however, and I want to see them reopen as soon as possible. Each CHO, therefore, is carrying out a risk assessment of every day care centre in its area. I cannot give a timeframe. We were hoping to open the centres in September, but then the numbers rose again. The situation is fluid, but I will keep the Deputies updated.

I met many active retirement groups, which are also anxious to get back into the community halls. People want to get back to playing bridge, and there are also knitting clubs and many others such groups. The whole thread running through the debate was that we have to compliment our older people. They did what was asked of them. It was very difficult cocooning for that length of time, but they did everything asked of them and they have been very stoic during Covid-19. Now, however, they want to get on with their lives and get back into the community. We will work very closely with the active retirement groups to ensure that happens.

I also met several Deputies regarding Jigsaw. New Jigsaw services will be rolled out in Bray and Thurles before Christmas. Jigsaw services now have 66% coverage throughout the country, but it will be great to see more such services available. Many people also spoke about suicide and tomorrow is international suicide prevention day. Last Friday, I was involved with the launch of the suicide statistics for last year. Unfortunately, as somebody said earlier, we lost 431 people to suicide last year, that is twice as many as were killed in road traffic accidents. I am not for one minute trying to lessen the tragedy of road traffic fatalities by making that comparison. Some 431 families were devastated by the loss a loved one to suicide last year. Connecting for Life is Ireland's national strategy to reduce suicide and that was developed between 2015 and 2019. I will not say it has gone out of date, but I will renew it so that process continues to 2024. That is very important.

The final matter to which I will refer relates to the Central Mental Hospital, which is currently located in Dundrum but which is no longer fit for purpose. It will be moving to the new National Forensic Mental Health Service facility at Portrane very soon. I will come before the House again soon with legislation to change the currently specified location for the Central Mental Hospital in Dundrum to the new facility in Portrane. I hope it will be possible to get support from across the House for that Bill. I have ensured that it will be simple, stand-alone legislation.

I thank so many people for coming in tonight and sharing their perspectives. If I have missed anything, we will pick up on the relevant questions and come back on the issues to which they relate.

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