Dáil debates

Wednesday, 27 January 2016

Topical Issue Debate (Resumed)

Mental Health Services Provision

1:20 pm

Photo of Seán KennySeán Kenny (Dublin North East, Labour)
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I thank the Ceann Comhairle for selecting this issue and I thank the Minister for coming to the House to respond. Before I start, I wish to pay tribute to Deputy Neville and to his distinguished record in the House, particularly on the issue of suicide. Like him, I am not contesting the next election, but I hope to get an opportunity later, when I speak on another Bill, to say my farewell. At present, however, I am anxious to raise this issue on behalf of a family in Donaghmede in my Dublin North-East constituency, with their consent to refer to the details of their case.

Their adult son, Igor, who suffers from autism, has been under the care of the HSE mental health and disability services for more than five years, and since last year he has been an inpatient of the acute psychiatric unit at the Ashlin Centre in the grounds of Beaumont Hospital. It has been acknowledged by the HSE mental health and disability services that Igor's needs would be better met by a placement in a residential care setting rather than in an acute psychiatric unit, and his parents have been assured that the HSE is working proactively in progressing this solution. The problem that is causing anxiety to both Igor and his parents is the delay in providing the funding for the provision of a suitable residential placement. His parents were informed on several occasions in recent months that a decision would be made very soon. Most recently, they were told that a decision would be made yesterday, but their hopes, which had been raised so many times previously, were dashed once again. They sent me an e-mail yesterday afternoon, which I will quote with their permission:

We received a call from our social worker today to say Nua [the placement centre] can go ahead with referral but meeting regarding funding is not for another two weeks, when we were told it would be today or tomorrow. We were absolutely devastated over this and cannot understand how disability and mental health cannot meet to discuss our case.

They have also described to me the effect of the ongoing delays on Igor, which is very apparent when they visit him.

The reason I raise the matter in the House today is to try to get clarification of why the decision on funding continues to be deferred in this case.

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
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As Deputy Seán Kenny said, there will be another opportunity to mention the fact that he is not standing in the next election. I will not say he is going away or retiring because I do not believe anybody ever retires entirely from politics.

I thank the Deputy for raising this matter today and I am pleased to outline the position. Deputy Seán Kenny and I have already had a discussion on this and, hopefully, we will do more than what is in my formal reply. The modern mental health service, integrated with other areas of the wider health service, extends from promoting positive mental health and suicide prevention through to supporting those experiencing severe and disabling mental illness. It includes specialised secondary care services for children and adolescents, adults, older persons and those with an intellectual disability or a mental illness. The development of a mental health service is a priority for the Government. We have provided an additional €160 million inring-fenced funding over 2012-16 to modernise mental health services in line with the commitments in A Vision for Change and the programme for Government. This provided approximately 1,150additional posts to enhance mental health and suicide prevention services generally. Of these, approximately 947 had been recruited as of the end November 2015, while the remainder are at various stages of the recruitment process.

The Ashlin Centre is a centre caring for patients with a range of mental illnesses. In view of the sensitivities involved, although I understand that the parents of this young man have given the Deputy permission to speak on the matter, I do not propose to go into great detail about the individual circumstances. However, as I mentioned, I have spoken to the Deputy in a private capacity and he has outlined the young man's circumstances to me. I am informed that the person in question is under the care of a consultant psychiatrist and receiving a high level of nursing and multidisciplinary care. The multidisciplinary team involved will work actively to ensure that whatever supports are required are in place to enable this person to transfer to the most appropriate care setting when they are ready to be transferred or discharged. I understand that north Dublin mental health services are currently working with a provider with a view to assessing and accessing an appropriate residential care package to meet this person's future care needs. The HSE has assured me that it will keep this person's family updated on developments, as the Deputy has confirmed with regard to the communications that have occurred with the family.

It is quite difficult to go into detail when one is talking about an individual case, but I have assured the Deputy that I will make further inquiries. I am sure the resolution to this young man's difficulties will be achieved shortly.

Photo of Seán KennySeán Kenny (Dublin North East, Labour)
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I thank the Minister. I accept that the Government has provided additional funding for this area during its term of office and that additional posts have been created. Nevertheless, the question regarding this young man, Igor, remains, as well as the fact that his family has not received a definite timescale for his transfer from the psychiatric unit to a care placement in a more residential setting. I accept the Minister's statement that there is confidentiality surrounding this issue but I am heartened by the fact that she will make further inquiries. I hope there will be a result quite soon.

On a more general level, and while I have time to raise this, there is the general question of the suitability of an acute psychiatric unit as a place to treat an autism sufferer. I accept that it can be difficult to deal with an autism sufferer but, as a lay person without any medical qualifications, I do not consider an acute psychiatric unit the best place for a person who has autism. I hope that this matter might be addressed again when policy is being formulated.

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
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I will respond on the general point, as it is not appropriate to go into the details of this young man's case. Conditions such as autism, Asperger's syndrome, intellectual disability, acquired brain injury and dementia are not preventatives of poor mental health. Sometimes, a person who has autism or Asperger's syndrome can become acutely unwell mentally. It does not always sit side by side, but it happens. That is the reason we must be very careful to be clear about how we deal with people. Of course, if the only issue is autism, the person should not be in an acute unit. However, we do not know that. It could well be the case that the person has difficulties with their mental health as well.

That is the reason that this year, with the €35 million we have secured in the budget, we will develop a dual diagnosis service, which we have not had previously and do not have at present. We are in the process of developing it. Until now, if a person had a difficulty with his or her mental health and also had a chronic alcohol problem, for example, the people in mental health services could quite correctly say that the person could only come to those services when he or she was dry, while the people who dealing with the addiction could equally say it was a mental health problem. The dual diagnosis element is something we must develop. It could very well be the issue in this case. I am not certain, but it is the case in some instances that people who have an overarching condition could have a mental health problem as well. I believe the dual diagnosis clinical pathway should be able to deal with that.

1:30 pm

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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I also wish Deputy Kenny the very best on his retirement. As one Galway person to another, I bring him good wishes from the county.

Photo of Seán KennySeán Kenny (Dublin North East, Labour)
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Go raibh maith agat.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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We will keep in touch.