Martin Browne (Tipperary, Sinn Fein) | Oireachtas source

The fact that this Bill was subject to so much delay and will not be introduced in the lifetime of the Government indicates the lack of urgency the Government ascribes to mental health services. It is a shame that the level of urgency shown in closing inpatient psychiatric beds in Clonmel has not been applied to the review of the Mental Health Bill, but that appears to be the standard approach of this Government. There is a crisis in communities across the country. We have a lack of acute care and a lack of crisis care in parts of Tipperary. Instead of acute services being available when and where people need them in south Tipperary, they must travel to Kilkenny. When this decision to move acute care outside the south Tipperary area was made, where were the measures to deal with the subsequent level of demand for such services locally? We have a new step up, step down support in Haven House, but no crisis beds. Adults and children alike have to present in the unsuitable surroundings of an emergency department.

Little has changed apart from the brilliant work done by the voluntary organisations. There is outreach in Tipperary. The availability of the Jigsaw service in Clonmel has been hampered due to staffing issues. This affects any notion of early intervention for young people. The resources are not present in north Tipperary to provide outreach services outside of Thurles town. The possibility of the HSE assisting in providing a Pieta House outreach service in the west Tipperary area is something on whichI have also been workng. The HSE is dragging its heels on funding and funding remains an issue there. Will the Minister of State work with Pieta House on this, because it has been going around in circles for quite some time now?

Sinn Féin would deliver universal counselling in primary care and State-wide access to integrated mental health and wellbeing community services, including Jigsaw. We have a plan to make the system work. Locally, we also see a high level of turnover in clinical areas, to such an extent that people in receipt of treatment can find themselves in the dark about their own care, then they suddenly find out they are being assigned a new psychiatrist. I am referring to a particular scenario which I am aware of, but it is not isolated. People need the certainty of continuity of care without having to adjust to sudden changes. The same is the case for clinicians' ability to pick up where the other left off.

This brings me to youth mental health services. The vacancy rates on CAMHS teams in Tipperary is beyond unacceptable. The number of referrals declined in the two CAMHS teams in 2023 amounted to 214 out of 297 referrals. How can this be considered a service that embraces the mental health challenges experienced by young people? It is welcome to see that CAMHS will be regulated but I have two wishes here. When will it happen? We cannot wait for the Bill to go through the Oireachtas. CAMHS needs to be regulated by the Mental Health Commission immediately. The second issue relates to the level of vacancy in our CAMHS teams. It essentially reduces what there is to regulate. The shortcomings in workforce planning are leaving communities and young people without.

Sinn Féin would implement a multi-annual strategic workforce plan and significantly increase graduate and postgraduate training places to address the near-collapse of mental health services in inpatient, community and primary care settings. For adults and young people who are using drugs to self-medicate, where is the integrated staffing to provide dual-diagnosis services? Sinn Féin will legislate to obligate any Government to uphold the no wrong door policy and support health and social care services to implement such policies. I appreciate that the Bill states the gardaí will no longer do the work that HSE-authorised officers should have been doing. I want to know the details of when and where these changes will be implemented. It is something I have dealt with in the past. The current situation is not fair on gardaí or the persons involved.

I have a real concern that this Bill does not legislate to ban admitting children to adult inpatient psychiatric wards. This indicates to me that the Government considers itself to be incapable of dealing with this problem. Tipperary has been failed by this Government's approach to mental health services. Young people desperately need to see CAMHS reformed, properly regulated and staffed. Too much damage has been done through what essentially in certain circumstances has been a distant approach that was not capable of providing crisis care.

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