Dara Calleary (Mayo, Fianna Fail)
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I thank the Ceann Comhairle's office for giving me the opportunity to raise this issue and the Minister of State, Deputy Kathleen Lynch, for being present. Just before Christmas, staff at the Ballina psychiatric unit at St. Joseph's District Hospital in Ballina and at Teach Aisling, a dedicated unit in Castlebar, were informed that unless they could produce what were termed "viable alternatives", these two units would be closed at the end of February and they would be transferred to the acute unit at St. Teresa's, the main mental care unit in Castlebar.

As the Minister of State can imagine, the staff at both units and across Mayo give a superb service. They are selfless in their dedication not just to their patients but to patients' families and to the communities which they serve. They are absolutely devastated by the consequences of this decision, particularly for the nurses in Ballina, who will be transferred into Castlebar, and for the patients at Teach Aisling, who are a particular kind of patient. They will not get the kind of service or attention in a central acute unit that they are getting at present. The irony in the case of Teach Aisling is that it is being used by the HSE as a prototype of how services should be delivered. In Ballina, the service has ten nurses attached and is currently serving 60 service users. It provides in-care treatment and also provides 24-hour nursing care to individuals with chronic mental illness and supports those in the community with medication and advice.

I compliment the Minister of State and everybody involved in the superb "The Frontline" programme last night. "Operation Transformation" is also on at present and I believe we are at such a stage in this country that an "Operation Transformation" should be applied to mental health as it is to obesity. The difficulty with last night's programme is that it was a one-off. I hope the Minister of State had a chance to have a discussion with Dr. Eleanor Fitzgerald Loftus, our local coroner, who would have filled her in on the difficulties we are facing in Mayo with regard to mental health.

Although the HSE management locally have told me it is not a final decision, they are informally telling everybody it is. The treatment of people in the community in what is geographically the third largest county will suffer. The range of services available within the north Mayo community, which are keeping people in north Mayo in their homes, will suffer. The acute unit in St. Teresa's, which is already under enough stress, will be put under more stress and people will suffer. There is no way around this.

I know the issue arises because of retirements and I know that the Mayo psychiatric services are suffering more retirements than normal at present. However, the level of retirements is not the same within the Ballina unit. These two units are being closed to ring-fence the acute unit at Castlebar.

I commend the Minister of State with regard to the €35 million and the 400 posts as this is probably down to her persistence and that of her predecessor, Mr. John Moloney. If we can get some of those 400 posts with a view to maintaining these services, we will go a long way towards protecting mental health services in Mayo. I heard the Minister of State talking on "The Frontline" last night of her trip around Wexford yesterday. I invite her to come to Mayo to see for herself the services on the ground provided by the HSE but also by Mayo mental health services, and to see what is at risk. I look forward to her response.

Kathleen Lynch (Cork North Central, Labour)
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I thank Deputy Calleary for raising this issue. He is probably aware I have had an interest in this area not just since I got this job but for many years, and I have worked very closely with his colleague, the former Minister of State, Mr. John Moloney. We should never forget that what we are doing now is simply a continuum. Others have been here before and there will be others in the future. It is about ensuring that forward momentum continues.

The unit in Ballina referred to by the Deputy, which is part of the district hospital, provides inpatient and respite beds as well as a day-care centre and outreach services to patients with severe and enduring mental health conditions. The unit currently caters for four residential patients and also provides four respite beds. Teach Aisling, located in Castlebar, is a ten-bed inpatient facility for clients with severe and enduring mental illness. It is a high support hostel which also provides rehabilitative outreach services.

Mental health services across all regions are continually reviewing the provision of service to their population to maximise the balance of service access within the available resources. Mental health services in Mayo are currently reviewing their psychiatric services in the context of the recently approved HSE service plan for 2012. The process will include consultation with service users and consideration of how safe and quality services can be provided within available resources. The expenditure reductions necessary in 2012 will challenge all areas of the health system to provide continuity of services that are both appropriate and safe for patients. As in other care areas, efficiency and other savings will be required from the mental health service nationally which will necessarily involve some rationalisation and reorganisation of services at local and regional level.

In spite of this, I am glad to say that it was possible to secure an additional €35 million for mental health, in line with our programme for Government commitments. This funding will be used primarily to strengthen community mental health teams in both adult and children's mental health services. It is intended that the additional resources will be rolled out in conjunction with a scheme of appropriate clinical care programmes based on an early intervention and recovery approach. Some of the funding will also be used to advance activities in the area of suicide prevention and in response to self-harm presentations, and to initiate the provision of psychological and counselling services in primary care specifically for people with mental health problems. Some provision will also be made to facilitate the relocation of mental health service users from institutional care to more independent living arrangements in their communities, again in line with A Vision for Change.

It is important that we get best value for money from our available resources. Duplication of mental health services needs to be avoided in order to provide a more streamlined service. We need to co-ordinate our efforts and work together to develop our mental health services in line with A Vision for Change recommendations. In essence, we need to provide more with less. This has already been successfully achieved in mental health service provision in other areas, Wexford being one where I have seen this working.

I am committed to working closely with the HSE and voluntary agencies to introduce programmes and services which will deal more effectively and appropriately with the issue of mental health. The time for dealing with mental health has come. I am glad to have the opportunity at times such as this to respond, even to individual cases. I will definitely take on board the Deputy's kind invitation.

Dara Calleary (Mayo, Fianna Fail)
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I thank the Minister of State for her reply. I assure her that in the context of the geography of County Mayo there is no duplication of service between Ballina and Castlebar. A considerable round trip is involved for those who now use the service in Ballina but who will be forced to go to Castlebar if this move proceeds. For the type of client who is being treated in Teach Ashling there is no duplication of service. They are getting a very specific treatment there which they will not get in St. Teresa's.

We all agree with the need to strengthen community mental health teams. However, if the closure of the Ballina unit goes ahead, ten nurses will be withdrawn from mental health treatment in Ballina and sent to the acute unit. That will destroy community mental health provision in north Mayo and west Sligo. People who do that job at present are unsung heroes.

I agree with many of the Minister of State's aims. However, if this decision goes ahead what may happen will fly in the face of many of those aims.

This is the second time in two months I have had to use the topical issue debate to raise the further downgrading of services at Ballina District Hospital. There seems to be a plan within the HSE, the Department of Health or somewhere, to close down that hospital. I can assure the Minister of State this will not happen on my watch. In one of the biggest towns in the country, the third biggest in Connacht, we will not stand by while our health services are being dismantled in this way. It is my job to highlight that. I look forward to welcoming the Minister of State.

Kathleen Lynch (Cork North Central, Labour)
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There are four areas in the country where, with the co-operation of the voluntary service users and the professionals involved, we have managed to roll out what is considered the model in regard to mental health services, namely, high-support hostels, day hostels and community-based mental health teams. In the areas I have looked at where this has been done the service is extraordinary. It serves both the service user and the professionals who work within it. It has changed the view of all as to how the service is delivered; the professionals, the community and the service users. That is what we want for all areas and that is what the €35 million is about. It is about ensuring that the posts we do not have at present, those we are missing from the teams, are put in place in order that people can stay well within their own communities.

The Deputy is right. Closing down units where people are supported within their own community is not what A Vision for Change is about. That programme is about maintaining people in their own community and ensuring they stay well within that community. The last thing we want is to have ongoing admissions to acute units. In Wexford, south Kilkenny and Waterford, a vast area, the admission rate to the acute unit has been cut by 50%. People are getting an extraordinary service in the area and that is what we want everywhere. With the additional money and the plan that is in place one hopes we will also have that service in areas such as Ballina and throughout County Mayo.