John Lyons (Dublin North West, Labour)
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Yesterday, service users of Tús Nua, which is a mental health day centre service in Ballymun, were informed by the staff of the imminent closure, most likely in September, of the day centre service in Ballymun for people in the area who are suffering with mental health related issues. Before that information was relayed to some of the service users, approximately 15 of those users came to my clinic yesterday morning with their concerns. If nothing else, it gave me a first-hand insight into who these people are and how the proposed closure of this service would affect them.

Tús Nua is a one-stop-shop for these residents. They explained to me that essentially it has become their lifeline. As I witnessed yesterday, these people are in perhaps the most vulnerable category of people in the area I represent in Ballymun. They rely heavily on this service. They see it as a place where they can drop in, and some of them drop in four or five times a week. It is where they have opportunities to chat to a professional and to look at ways to deal with their mental health issues, be it through arts and crafts or cooking. They also have the opportunity to look at the issue of money management and other basic life-related issues. Clearly, they were very concerned and I have taken on their concerns, given that they are very vulnerable people.

I understand that the proposed closure of Tús Nua, and the Minister may correct me if I am wrong in that regard, is based on a report from the HSE. It was initiated in 2013 in the HSE north Dublin city area, which comprises part of my constituency, to review all day centres. Obviously, given the imminent closure of the Ballymun Shopping Centre and the fact that the service is located in that shopping centre, there was a need to address the day services there, in particular. However, my concern is the 44 or 45 service users who essentially see this centre as a lifeline. They consider it a social outlet, a support structure and a learning environment. I received an e-mail from the daughter of one of the service users in which she told me that the only time her mother goes out during the week is to visit the service.

The people who use the service are exceptionally vulnerable. They are fearful of change. Fundamentally, they must be cared for and their needs must be taken into account before there are any changes. I am hearing proposals that some of these people might have to use a service elsewhere, such as in Coolock or further afield. These are people who will not get on a bus by themselves. This centre is located within less than a mile from their home. They can walk to the shopping centre, go into the day centre and have that connection. Often, that connection makes the difference between seeing the sun or not seeing it in their lives that day. I am very fearful and the service users are exceptionally fearful of what change might lie ahead.

I do not see why it is necessary to have a day service outside Ballymun when there is one in Ballymun already. Ballymun must continue to have a day centre mental health service provision. Not only that, it must be a high-quality service provision. I look forward to hearing the Minister's comments on this. Incidentally, I have been trying to get my hands on the report that suggests these changes but I have been unable to access it. It is hard to have a proper debate on this matter when some of the information has not been made available to me. I understand the information is probably private but it is hard to debate an issue when one does not know everything about why the report is making these proposals.

Alex White (Dublin South, Labour)
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I am replying to this Topical Issue on behalf of my colleague, the Minister of State, Deputy Kathleen Lynch, and I thank Deputy Lyons for raising this important matter.

The Deputy will appreciate that the HSE has statutory and operational responsibility for the planning and delivery of services at local level. North Dublin mental health services provide a range of adult mental health services within the specialties of general psychiatric, psychiatry of old age and a rehabilitation psychiatry service. This encompasses various settings such as service user homes, acute inpatient facilities, day hospitals, day centres and supported community residences. The service the Deputy refers to, which is community based with a focus on recovery principles, is delivered by consultant-led multi-disciplinary teams incorporating staff from a range of disciplines, including nursing, social work, occupational health and psychology.

The Deputy is correct that in 2013 the HSE, as part of the Dublin north city mental health service plan, identified the need to review all day centres within the area in line with A Vision for Change. A review group was established by the Dublin north city mental health management team with the following remit - to identify all mental health day centres in Dublin north city, general adult psychiatry; to review services provided within each day centre; to make recommendations, if required, to ensure that each day centre was fulfilling its brief; and, examine if clients' needs could be met in a more appropriate environment.

In the case of Tús Nua, the review group found that the day centre, which is situated on the upper floor of Ballymun shopping centre, was old and in poor condition, with only one fire exit from the building. There is no lift access and the shutters on the front window cannot be opened due to security concerns. Having considered all the issues, the review group recommended to the Dublin north city mental health management team that it would be best in the circumstances to close the Tús Nua facility. It should be further added that the lease on these premises has expired and, due to the regeneration plan for Ballymun, it cannot be renewed. In addition, the need to vacate the Ballymun shopping centre to allow the regeneration plan to proceed has left this service in a vulnerable position, and the HSE management cannot safely recommend the service continue.

I understand that the HSE is to establish an implementation group under the chairmanship of the clinical director and that an independent assessment of the needs of those attending the centre will be carried out. This assessment of needs will inform the process going forward and will ensure that the needs of service users, which is the main preoccupation of Deputy Lyons, continue to be met. The implementation group, as part of its remit, will communicate with all the relevant stakeholders during this period of change. I can assure the Deputy it is not the intention of the Dublin north city mental health management team to close this facility until the process of consultation with all relevant stakeholders is complete and appropriate alternative placements have been sourced.

Any changes that arise as part of this process will be communicated to patients and staff in advance of any change taking place. Accordingly, I would like to assure the Deputy that the HSE will, at all times, put the needs of service users to the fore in the relocation of this service.

John Lyons (Dublin North West, Labour)
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I appreciate the Minister of State is speaking on behalf of the Minister of State, Deputy Kathleen Lynch, who has responsibility for this issue. However, it sounds like the door is already bolted on this issue. It is very frustrating to see in the very last line of the response from the Department that the HSE will "put the needs of service users to the fore in the relocation of this service". The needs are such that they cannot travel beyond where they travel to as it is. These are people who are so isolated from the general well-being of society that getting on a bus is as traumatic as can be. If the HSE is putting the needs of service users first, it will take into account that these are the genuine needs of many service users. It is not that they will not, it is that they cannot. Because of the situation in which they find themselves in their lives due to their mental health issues, they are just not able to engage in society. They have found some way to engage with a local service in Ballymun but if they have to move to another venue outside Ballymun, it will see these people put in an even more vulnerable position.

I am not playing to the gallery. I witnessed these people yesterday. They are so bloody vulnerable that they will not be in a position to travel elsewhere. If the HSE thinks it is acceptable to assess their needs and to ignore the reality that most of these people cannot get on a bus and engage in the way we do, it is not listening to their needs.

We all know of the shopping centre issue. However, where there is a will, there is a way. The HSE, with Dublin City Council, has a social inclusion unit. It needs to look at these people within their community and see what can be done with the new buildings in Ballymun in the hope that the new service can be located within the area, so all 44 or 45 members can continue to access this service.

Alex White (Dublin South, Labour)
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I thank the Deputy again for raising this issue. I understand the points he has articulated in regard to the individuals concerned. He has obviously met with the people concerned and he has a good appreciation of their needs and, perhaps, the limitations that apply in regard to people's ability to travel or to transfer. I understand that. While I would not hazard any further response in regard to the detail of this because I simply do not know all of the individual details, I would reasonably expect, as I know the Minister of State, Deputy Lynch, would, that those needs and limitations would be taken fully into account in regard to the planning of alternative facilities to address the very obvious needs that exist.

I assure the Deputy I will relay to the Minister of State, the Department, the officials concerned and the HSE the importance of taking completely on board all aspects of the situation which the Deputy has articulated. I thank him again for raising the issue.