Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this important matter. The continued enhancement and improvement of our mental health and suicide prevention services remains a priority for me. I was pleased, therefore, to secure unprecedented funding of €1.149 billion for HSE mental health next year. This is an increase of €47 million over 2021.

Next year's new development funding will provide for the recruitment of 350 new staff across mental health and will allow for new initiatives in community mental health teams, including CAMHS, out-of-hours supports, specialist eating disorder services and mental health services for older people. It will provide for dedicated funding to progress the national clinical programme on dual diagnosis for people with addiction and mental health difficulties, including the recruitment of staff in this particular area. The details of these new measures are being finalised as part of the HSE national service plan 2022, which will be published shortly.

A key approach of our new mental health policy, Sharing the Vision, is to improve access to all relevant services, including more integrated and person-centred care. Sharing the Vision recognises that people with a dual diagnosis should have access to appropriate mental health services and supports by addressing existing service gaps and developing stepped, integrated models of care. The national implementation and monitoring committee is tasked with driving and overseeing implementation of the policy's recommendations, including those relating to dual diagnosis. I am pleased to say it is progressing well in its work. Importantly, the dual diagnosis programme has a draft model of care, which takes account of service user views. It describes the clinical pathway for service users with substance misuse and moderate to severe mental health difficulties, with links to primary care substance misuse, community mental health and acute services. This is informed by international best practice and the experience of a national working group.

A national clinical lead and a programme manager for dual diagnosis have been appointed. They have quickly established a multidisciplinary working group to finalise the model of care and develop pilot sites to start the programme. HSE mid-west community healthcare is in the process of developing a dual diagnosis service and is establishing a national pilot site for this. This will be a consultant-led multidisciplinary team based in Limerick, with reach across the wider mid-west area, including north Tipperary. The multidisciplinary team will include peer workers and counsellors with specific expertise relating to mental health and addictions.

It is of note that the national drugs strategy, Reducing Harm Supporting Recovery, sets out the Government's strategy to address the harm caused by substance misuse in Ireland up to 2025. The Department of Health provides over €130 million to drug and alcohol services to support the strategy. In line with Sharing the Vision, there will be an enhanced focus moving forward on the development of tiered, integrated supports between primary care, addiction services and specialist mental health services to ensure the best possible outcomes for people with a dual diagnosis. The HSE already provides support for such work, where it aligns with the local objectives identified in the HSE service plan. This is done through a service level agreement for NGOs providing services to, or on behalf of, the HSE.

With respect to funding that is available for CARMHA, every organisation that wishes to apply for ongoing funding must make a business case to its local HSE community healthcare organisation, CHO, office. In the case of CARMHA, the relevant office is the CHO 3 office for north Tipperary. There is a process in place and service level agreements are arranged with many agencies. Criteria must be met, and the criteria are analysed. After all, taxpayers' money is at stake. There are over 1,000 voluntary organisations in the country. CARMHA must apply, through the local HSE CHO office, for funding to see if it can reach a service level agreement if its services are needed by the HSE.

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