Dan Neville (Limerick West, Fine Gael)
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Question 5: To ask the Tánaiste and Minister for Health and Children her plans for introducing adequate child and adolescent psychiatric services consisting of multidisciplinary teams. [9716/05]

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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A working group on child and adolescent psychiatry was established by the Minister for Health and Children in June 2000 to make recommendations on how child and adolescent psychiatric services should be developed in the short, medium and long term to meet identified needs.

In its first report, the working group recommended the enhancement and expansion of the overall child and adolescent psychiatric services as the most effective means of providing the required service for children with mental illness. The group found that the internationally acknowledged best practice for the provision of child and adolescent psychiatric services is through the multidisciplinary team and the funding of this area has been a priority for my Department in recent years. Since 1997, additional funding of almost €19 million has been provided to allow for the appointment of additional consultants in child and adolescent psychiatry, the enhancement of existing consultant-led multidisciplinary teams and the establishment of further teams. This has resulted in the funding of a further 19 child and adolescent consultant psychiatrists. Nationally, 52 such psychiatrists are in our complement.

The first report of the working group on child and adolescent psychiatry also recommended that a total of seven child and adolescent inpatient psychiatric units for children ranging from six to 16 years should be developed throughout the country. Project teams have been established to develop child and adolescent inpatient psychiatric units in Cork, Limerick, Galway and the Health Service Executive eastern regional area at St Vincent's Hospital, Fairview. Approval to tender for design teams for the units in Cork, Limerick and Galway was given by my Department recently. Inpatient services for children and adolescents are provided at Warrenstown House, Dublin, and at St. Anne's in Galway.

The Health Act 2004 provided for the Health Service Executive which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes responsibility for the provision of mental health services. An additional €15 million has been made available for the further development of mental health services in 2005, bringing the total spend on mental health to approximately €725 million. A portion of this funding, the details of which are yet to be finalised, will be allocated to child and adolescent mental health services.

The future direction and delivery of all aspects of our mental health services, including child and adolescent psychiatry, will be considered in the context of the work of the expert group on mental health policy, which is due to report this year.

Dan Neville (Limerick West, Fine Gael)
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Does the Minister of State agree there is an urgent need to ensure proper beds and facilities for children under 16? The Irish College of Psychiatrists recommends in the report that the Minister of State mentioned that there be 144 beds available for people under 16. However, at present there are approximately 20 in the country. When those between the ages of 16 and 18 are included, it is clear that an extra 80 beds are required, making a total of 224. There are very few or no dedicated services for those aged between 16 and 18. In my area, there are children as young as 13 in adult psychiatric hospitals.

Does the Minister agree that it is totally appropriate, since as many as 18% of children under 16 and 20% of those between 16 and 18 will experience serious psychological or psychiatric problems? One must bear in mind that 11,500 people, mainly young, attended accident and emergency departments having attempted suicide last year. Does the Minister agree that the lack of child and adolescent psychiatric services is a factor in that level of attempted suicide and in successful suicides among young people? It is accepted that early intervention of a psychiatric or psychoanalytical nature among children and adolescents prepares them for difficulties experienced later. The lack of intervention for those in crisis is a major risk factor in levels of suicide and attempted suicide.

The ongoing highlighting by the Irish College of Psychiatrists and others of the lack of services in the context of the level of attempted and successful suicides is a serious issue.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I agree in general terms with the Deputy's suggestion that imbalance in mental health can be a factor in the cause of suicide, though it is clear that many factors are involved, and I am not able, as Minister of State with responsibility for policy in the area, to give a diagnosis or clinical assessment, since I do not have the same expertise as the Deputy. However, regarding the general question of the mental health services for children and adolescents, it has been recognised for several years that there are difficulties; that is why the reports were commissioned. On foot of those reports, the decision was recently taken to allow the design teams to go to tender.

The project teams have been established to develop child and adolescent inpatient psychiatric units in Cork, Limerick and Galway. That has now been sanctioned, and that is the key point. The proposed unit in Cork will consist of 20 in-patient beds, the unit at Dooradoyle, County Limerick, will have 14 in-patient beds, and the child and adolescent unit in Merlin Park Hospital, Galway, will have 20 in-patient beds. There will clearly be an increase in capacity when those plans are implemented.

Dan Neville (Limerick West, Fine Gael)
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The Minister of State announced again that €15 million has been made available for the development of psychiatric services. Bearing in mind that this serious issue will affect one in five people at some stage of their lives and that the development of psychiatric services has been neglected for decades, that €15 million, which is less than the cost of the Punchestown project and only 25% of that of electronic voting, is absolutely unacceptable. It is an absolute disgrace to announce that for the development of psychiatric services when they need a multiple of that sum each year to bring them into line with the standards of the 21st century.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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As I pointed out, approval has recently been given to tender for the design teams for the units. Regarding the units in Cork, Limerick and Galway, tender for design work does not require that much money. The Deputy rightly identified in his question that there is a lack of capacity in this sector, and we are addressing that.

Dan Neville (Limerick West, Fine Gael)
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I was referring to the €15 million.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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We have gone on with the expert working group, which has made certain recommendations. On foot of that, we have given approval to tender for design team. One cannot simply double or treble allocations if one does not have the capacity to deliver the service. One must plan for a service, and that is what we are doing on the basis of the report. We are planning an increase in the service's capacity. As the Deputy rightly said, existing in-patient services are inadequate. There is insufficient capacity in Warrenstown House and St. Anne's in Galway for national cohorts. Therefore, we are increasing the capacity. I will not enter into a discussion about expenditure tables, Punchestown or voting machines in this context. I am describing to the Deputy what is being done on this issue. The Government is aware of the problem and is dealing with it.

Dan Neville (Limerick West, Fine Gael)
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The €15 million is intended to cover all psychiatric services rather than simply those for children and adolescents. Is that not inadequate?

Séamus Pattison (Carlow-Kilkenny, Labour)
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We must move on.