Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I reiterate what my colleague, the Minister of State, Deputy Rabbitte, said in her opening remarks and thank all Deputies for the constructive and positive contributions to this important motion on the issue of CAMHS. I thank Deputy Ward for tabling the motion. Many of the same speakers were present last Thursday evening for three hours. We are here again today for two hours. I will be in the Seanad tomorrow. I welcome any opportunity we can get to shine a spotlight on mental health. We might be on opposite sides of the House, but I acknowledge Deputy Ward's advocacy for mental health every week. It is important that in one of the main slots of the day we are here talking about mental health. We can never talk enough about it. I also acknowledge Valerie O'Sullivan in the Gallery and the other people who have sat through this debate from start to finish. As my colleague stated earlier, the Government and myself are not opposing the motion. We welcome the opportunity to discuss the important topic of CAMHS, and I assure all Deputies that our children's physical and mental well-being is a priority consideration for the Government at all times. That has been reflected in the policies introduced to safeguard their well-being as well as the targeted initiatives outlined earlier by the Minister of State, Deputy Rabbitte.

There were questions about the mental health Bill, that is, the restructuring of the 2001 Act. That is queued for priority drafting at the moment and I will introduce it as soon as it is ready. There are approximately 140 heads in the Bill and it is complicated but it is scheduled for this session.

I wish to touch on what Deputy O'Donoghue said. He highlighted the issue of the 140 cases that were lost to follow-up in CHO 3, which encompasses the mid-west. He mentioned that there was a consultant no longer working there, with 140 files piled up. At that stage there were 3.5 consultant psychiatrists; there are now seven. Those files have now been dealt with. It just shows how easily there can be a pileup when there is not an adequate number of staff.

A couple of Members mentioned funding. We are reviewing the €11 million figure. It is likely associated with delayed recruitment to posts. Last year in the budget I allocated funding for another three eating disorder teams, more ADHD teams and a team for mental health with intellectual disabilities. It takes 12 to 18 months to recruit a full multidisciplinary team, but I reassure anyone listening that all the money for the mental health budget stays within mental health services and is not handed back or anything like that. My Department still has that money and it will be spent wisely.

As I have indicated on many occasions since becoming Minister of State, protecting the mental health of all our population, including young people, has never been more critical. The Mental Health Commission's interim report shows that despite the progress of recent years, our services can fall short. We were here 12 months ago debating the Maskey report. As a result of that report, I engaged with the commission. I knew that the commission was doing a thematic report on CAMHS and I asked it to expand it and to look much deeper. I also funded it to bring in consultant psychiatrists from Scotland and the North in order that Dr. Finnerty would have the support and the resources she needed to do it. We have five CHOs done - CHOs 3, 4, 5, 6 and 7 - with four to come. We will be back here in a few months debating this, but it is important that I have these two reports coming. I have the independent reviews coming from the HSE as well, and I will have the Mental Health Commission's full report, but the two of them are working in parallel. We will have data we never had previously. There was no point in my shying away from the Maskey report. I had to try to build confidence in all the CAMHS teams. I had to give parents and children confidence. The only way I could do so was to initiate a review and an audit. That is why we are here now, 12 months later, debating this. I welcome the report and welcome equally the focus on service delivery and patient safety. I noted last Thursday that I await both the commission's final reports.

The need to act decisively and to do what is necessary to protect children using our mental health services is of paramount importance. We are immediately developing a model of care for prescribing practices in CAMHS. In the coming days I will organise a series of round tables with relevant stakeholders, including the College of Psychiatrists of Ireland. The HSE has confirmed to the Department of Health that the issues raised in the Mental Health Commission's report are being proactively acted on at national level so as to mitigate risk throughout the system as a whole and beyond the CHOs reviewed to date.

As part of the opening statement this evening, the Minister of State, Deputy Rabbitte, highlighted a significant investment that has taken place in community organisations across the country. I thank all those organisations and their staff for the incredibly important work they do every day. As has been noted, only 2% of children will need the support of CAMHS specialist services, with the majority of mental health supports for children and young people being met within the community. The €80 million provided by the Government to community organisations in 2022 highlighted that a variety of pathways are available to access mental health supports. For example, Jigsaw was allocated approximately €12 million in 2022 to provide essential supports for children. Jigsaw provided more than 2,600 appointments last year and 85 mental health workshops. Along with the significant funding to that service in the past year, €1 million was provided to MyMind to continue to deliver free-of-charge counselling sessions to clients in more than 15 different languages. A further €1 million was provided through Mental Health Ireland for community and voluntary agencies promoting mental health and well-being. Telehealth services such as the seven-day crisis text line, 50808, also promote access to services, as do approximately 1,000 HSE-supported mental health services available through yourmentalhealth.ie, including further details regarding the services we fund: Belong To, Bodywhys, SpunOut, MyMind and many other State support services for young people.

We also know that technology often plays an important role in the lives of young people. The Department of Health and the HSE are determined to fully utilise opportunities offered by telehealth technologies to mitigate recruitment challenges and modernise delivery of mental healthcare. Telemedicine is a recognised part of healthcare in many parts of the world and has a history going back more than 20 years. Clinical staff are present in the room with the young person during the consultation, and initial service user feedback has been positive. In respect of telemedicine, the first consultation with the child or young person is always in person. It is something we have had to use especially in Kerry, where we have been challenged in filling the recruitment areas.

There are 500 more people working in mental health since this Government came into office, of whom 85 are working in CAMHS, but we have a lot more to do. I stress that any young person or his or her family who have concerns about their mental health or well-being should seek help without delay. Help is there, recovery is possible, and our wide range of care services provide real help that makes a tangible difference to many young people day in and day out. HSE Live is available to support any children or families with concerns arising from the interim report. Its freephone number, 1800 700 700, is open Monday to Friday from 8 a.m. to 8 p.m. and on Saturdays and Sundays from 9 a.m. to 5 p.m.

I take this opportunity to acknowledge the immense commitment and contribution our specialist CAMHS teams makes to so many young people every year. We can look back at the last few years and ask ourselves how we are faced with these challenges. We have seen an unprecedented 33% more referrals to CAMHS in 2020 and 2021. We also saw an unprecedented 225,000 appointments offered to young people last year. We have seen the CAMHS teams expand their remit to include another 21% of referrals with the same number of staff, so they have been working very hard.

I have visited quite a few CAMHS teams over the past 12 months, in Kerry, Waterford, Dundalk, Galway, Roscommon and quite a few more areas and I notice that all the CAMHS teams vary. I was struck by the young people I met when I went along to CAMHS teams, especially on the day I was in Dundalk. I usually go quietly into these places because they are mental health settings. I go in on my own and I speak to the staff and I speak to the young people if they are available. I was struck by one young girl there who was exiting CAMHS after four years. She told me she had 96 appointments over the four years and she had been seen every fortnight for four years. One of the things I am particularly worried about, and I said this last Thursday as it is something I am looking into, is the rate of acceptances of referrals across the country. It is as low as 38% in some areas and as high as 81% in others. I am not a clinical person and I am told some children meet the criteria and others do not but there is a huge difference in acceptance rates and that is something I want to explore.

I thank everyone for their comments; everyone had something positive to offer and we all deal with this every day in our constituency offices. As I said, I will not be opposing this motion.

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