Dáil debates
Tuesday, 2 February 2016
Other Questions
Mental Health Services Provision
4:00 pm
Mick Wallace (Wexford, Independent)
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68. To ask the Minister for Health if he has plans to put a 24-hour acute mental health unit in County Wexford; and if he will make a statement on the matter. [3923/16]
Mick Wallace (Wexford, Independent)
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I have raised this issue with the Minister of State before. One of the key messages of A Vision for Change was the need to reduce reliance on acute in-patient beds in cases of mental illness by strengthening early interventions by community mental health teams. Last autumn, In reply to my question, the Minister of State said the delivery of mental health services had been transformed. However, the people on the ground in Wexford strongly disagree with that. The community health teams do very good work but are only open until 5 p.m. To access these services, people need a referral from a GP, otherwise they go to Wexford A&E, from where they can be sent to Waterford A&E, all the while in mental crisis. According to the people on the ground, until things are better in the community services area we need a 24-hour acute service in Wexford.
Kathleen Lynch (Cork North Central, Labour)
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We will struggle for time now and as we have had this debate before I think it is important that rather than reading the set reply, which I am sure the Deputy will be supplied with, we should look at the services that are available in Wexford. The majority of the €18 million investment programme was spent in County Wexford on Tara House community mental health centre in Gorey, which is a day hospital; Tus Nua rehabilitation unit in Enniscorthy, which has 12 beds; Heavenview, which is a 14-bed unit; Millview, which is a 12-bed intellectual disability and rehabilitation unit in Enniscorthy; Farnogue psychiatry of later life unit and team headquarters, Wexford, which has 20 designated psychiatry of old age beds and 30 beds designated as part of the community nursing unit for the care of the older person; and the upgrade of Summerhill community unit, Wexford.
A Vision for Change recommends that as part of community secondary care provision, there should be a crisis house available in each catchment area. In July 2014, a new purpose built ten-bed crisis respite unit, seven day service, An Tearmann, opened in Enniscorthy for service users who are referred there through their mental health community team for respite care. I have already outlined the mental health services in operation in Wexford.
In addition, Wexford has recently received substantial funding which will enable it to continue into the future, a service of which I am sure the Deputy is very well aware. The mental health services in Wexford and the surrounding areas are now developing an infant mental health service for the area which is in compliance with A Vision for Change. One of the models we should look at in future should include respite and crisis houses and the type of innovative development that we see in Wexford. It is the Deputy’s job not to be satisfied but there has been substantial investment in Wexford and a completely new type of service.
Additional information not given on the floor of the House
The Waterford-Wexford Mental Health Services serves a population of approximately 278,000. The extended catchment geographic area stretches from Gorey in north Wexford to Youghal in County Cork. Mental Health Services in Wexford are arranged in accordance with national policy as reflected in A Vision for Change. The HSE, in addition to emergency and hospital care and community based services, has a comprehensive range of services available to people in Wexford in the areas of mental health, suicide prevention and substance misuse.
Following a closure order in 2010 from the Mental Health Commission, the acute mental health unit in St. Senan’s Hospital, Enniscorthy was amalgamated with Waterford Mental Health Services and is now provided for in a 44-bed acute in-patient unit in University Hospital Waterford. In addition, arrangements are in place whereby service users in north Wexford who attend Tara House mental health services in Gorey and require acute in-patient admission have access to five beds in Newcastle Hospital, Greystones, County Wicklow. To support the amalgamation of acute mental health services, a comprehensive €18 million capital investment programme was implemented, with the main developments taking place in County Wexford. These, for example, relate to additional bed provision or enhancement of facilities such as Tara House in Gorey, Tus Nua, Heavenview and Millview in Enniscorthy; and the Farnogue psychiatry of old age care unit and Summerhill community mental health unit in Wexford.
The Suicide Crisis Assessment Nurse, or SCAN, service in Wexford is a skilled mental health nursing service for Primary Care. This provides an accessible and quick response to GP requests for a timely assessment of those in suicide or self harm distress. The emergency department in Wexford General Hospital has a seven-day liaison nurse led service. In addition, and in line with catchment area criteria recommended in A Vision for Change, a new purpose-built ten-bed crisis respite unit has been opened in Enniscorthy. Many of the services I have outlined, and others in the area, operate a seven-day service, with significant opening hours.
I am satisfied that the significant and comprehensive service developments that have taken place or are currently planned for the Waterford-Wexford Mental Health Service area as a whole will ensure the provision of quality and patient focused mental health care across the region. In light of this, there are no plans at present to provide the type of service suggested by the Deputy.
Mick Wallace (Wexford, Independent)
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It is not my job to be dissatisfied. The services the Minister of State is talking about may reap rewards in the future. I hope they will. I was contacted recently by a woman who lives five minutes away from me. She told me that her 24 year old son tried to take his own life in late October 2015, which was his second attempt in four years. He slit his wrists and came very close to bleeding out. He was brought to Wexford General Hospital by ambulance. A few hours later, the hospital telephoned Christine and told her she would have to take Shane to St. Vincent's for surgery because he had severed two nerves in his wrist. At St. Vincent's they had to wait five hours on a trolley in A&E before he was seen. They carried out the surgery there but would not admit him to the psychiatric unit because he is from Wexford and outside the catchment area. As Shane has been diagnosed with a personality disorder, he is not deemed to be a threat to himself and is excluded from involuntary admission to treatment under the Mental Health Act. The psychiatrist at University Hospital Waterford said he does not need antidepressants.
Things are a little bit more difficult in Wexford than the Minister of State realises. I am not saying that she should realise it as it is difficult for her to know everything that goes on in the country. Wexford is the third most disadvantaged county in the country at the moment. We have 22% unemployment and the second highest suicide rate. In the short term, a 24-hour acute unit would meet many of the concerns of the people I have been talking to until the services the Minister of State has put in place are working better.
Kathleen Lynch (Cork North Central, Labour)
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On suicide prevention, aftercare and the process when people are in crisis, Wexford is now providing 12,000 counselling hours and has received additional funding. In addition, the suicide crisis assessment nurse service, SCAN, in Wexford is a skilled mental health nursing service for primary care. As the Deputy knows, primary care is provided on a 24-hour basis. It provides an accessible and quick response to GP requests for a timely assessment of those in suicide or self harm distress.
One of the areas I have concerns about is why people with a mental health difficulty have to come through A&E. Clearly, if they have a physical injury, it has to be assessed and put right. One of the things we will look at is the number of beds - whether it is the right number, whether we should have more or fewer beds and how people get admissions to an acute unit.
All these issues will be dealt with by the new group.