Maurice Quinlivan (Limerick City, Sinn Fein)

My colleague mentioned the pilot project, namely the community access support team, CAST, initiative that was launched in Limerick last October and commenced in January. The Minister of State was there at the launch. Like most things pertaining to mental health, the launch of the programme came two and a half years after we were advised it would commence. However, we got there in the end and in its short time in operation, the project has been successful. It involves a combined Garda and HSE support group that assists those facing a mental health challenge, particularly during out-of-hours periods.

The statement provided to the health committee today by Chief Superintendent Derek Smart from Limerick reads:

... it is important to note that since its introduction, CAST has created greater integration among statutory and voluntary agencies operating in the Limerick Garda division. It is grounded in international evidence and research showing co-response has delivered improved outcomes for adults requiring intervention at times of mental health crisis or situational trauma.

[...]

The early outcomes and available data are encouraging and have seen over 40 diversions from arrest and subsequent detentions under section 12 of the Mental Health Act 2001. A further consequence of this would have seen an admission to an emergency department and medical call-outs.

CAST has recorded over 1,700 operational hours of service in its first four months of operation and has seen more than 150 individuals interact with the project.

Our CAST forum clients are subject to levels of inter-agency work not witnessed in this jurisdiction previously.

[...]

[Another] significant finding under CAST has been a concerning gap in service for individuals who, following a detention under the Mental Health Act, receive a letter or advice to attend an approved centre such as a psychiatric hospital or emergency department.

He continued:

The person is not obliged to attend. And in practice, we have seen many individuals in acute psychological crisis simply walk away once released by gardaí, without ever engaging with services. To help bridge this gap, CAST has implemented a structured callback protocol, providing follow-up contact with individuals after their release, checking on well-being, assessing ongoing risk, and we attempt to re-engage them with services. While this offers some reassurance, and has yielded significant results - 142 recorded call backs completed - it is not, in our opinion, a substitute for legislative authority.

While CAST is in its infancy, it speaks to the commitments in the programme for Government and represents interagency collaboration in its purest form.

This was the opening statement from Chief Superintendent Derek Smart today. After his welcome contribution, of which I have only quoted a portion, I hope that as we advance this Bill, consideration will be given to additional funding to ensure the CAST project becomes permanent. Having spoken to senior staff in the HSE and Limerick gardaí, I can say that the project has already saved lives. While one senior garda told me it was a godsend, he remains concerned that CAST and the pilot project has not received its own funding but instead works out of existing budgets. In conjunction with the Minister for justice, will the Minister of State support this project and following the evaluation that will be carried out by UL, which all indications are will be positive, look at expanding CAST across the State?

See this speech in context