Dáil debates

Tuesday, 31 May 2016

Adjournment Debate

Mental Health Services Provision

9:05 pm

Photo of Pat DeeringPat Deering (Carlow-Kilkenny, Fine Gael)
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I wish the Minister of State at the Department of Health, Deputy Helen McEntee, every success in her new brief. I am sure she and the Minister of State, Deputy Eoghan Murphy, who is seated beside her, will do very well. I thank her for coming to the House to deal with this sensitive issue.

The provision of early intervention mental health supports and services for young people in Carlow is in a state of crisis. The Carlow regional youth service offers an early intervention counselling service and runs two projects. The first of these, the Folláine counselling service, offers one-to-one support for vulnerable young people who are experiencing difficulties in their lives. Unfortunately, in the past eight weeks, two 14 year old boys have died by suicide in Carlow town. This has had a devastating impact on our whole community and placed an unprecedented demand on the regional youth service support services.

In 2015, the Folláine counselling service worked with 103 young people. As of 27 May 2016, a further 76 young people had engaged with the service this year and the waiting list for an appointment currently stands at 12 weeks. The leading presenting issues are anxiety, emotional difficulties, depression, self-harm and bereavement. These issues are more acute for young people than in previous years and interventions are taking longer. As a result, the Carlow regional youth service can no longer accept new referrals for Folláine. With the exception of the psychological service and child and adult mental health services, CAMHS, Folláine is the only support service that provides early intervention support for mental health and well-being in young people in Carlow town, which has a population of approximately 22,000. The service currently receives funding of approximately €30,000 per annum or €400 per client.

The second project run by the Carlow regional youth service is the YARC project. To date, 47 young people have been referred for one-to-one support to YARC. This is an increase of 50% on the same period last year and again the presenting issues are more acute and require longer intervention. In 2015, the two YARC project workers worked with 70 young people, with September being the busiest month. Both the YARC and Folláine projects have had effective outcomes for their clients, including return to mainstream education, improved emotional resilience and progression to mainstream youth work opportunities.

Based on previous experience, September is also the busiest month for the Folláine counselling service. It is estimated that an additional 65 young people will require support from Folláine in 2016. Additional funding of €26,000 is required for this purpose. To continue to offer the services of the YARC project, the Carlow regional youth service urgently requires an additional youth worker to meet current demand for mental health services for young people in Carlow town. This would cost approximately €48,000 per annum.

I am extremely concerned about the lack of services available to support the emotional health and well-being of young people in Carlow. Existing organisations are best placed to respond quickly and effectively to the current and future early intervention needs in the town. These services support and alleviate demand on the Health Service Executive and Tusla specialist services.

The Carlow regional youth service is a complementary service provided to schools and also offers other statutory services. It was not established to replace HSE or TUSLA services. As matters stands, it cannot accept further new referrals with its current level of funding.

A task force is required in Carlow to address the current difficulties in the town. In addition to the two young people who recently died by suicide, two adults died by suicide in Carlow in recent weeks. Unfortunately, Carlow has the third highest rate of suicide by area of residence. Recent figures show that the area's suicide rate stood at 15.7 per 100,000 compared with a national rate of 11.3 per 100,000.

On 24 May, Carlow regional youth service hosted a meeting which was addressed by the psychologist, Dr. Eddie Murphy, and attracted more than 300 concerned parents. I ask the Minister of State to examine the issues I have raised and ensure additional funding is found for early intervention services and the establishment of a task force in Carlow.

Photo of Helen McEnteeHelen McEntee (Meath East, Fine Gael)
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I thank Deputy Deering for raising this issue. Mental health in general and mental health services are very topical and I hope they remain on the agenda. In that respect, I need the support of Deputy Deering and others to ensure that is the case.

The HSE national service plan for 2016 outlines a commitment to develop early intervention and prevention services for children and young people to ensure timely access to counselling and psychotherapy at the appropriate stage and to continue the development of such services into adulthood. These early intervention and prevention services have been prioritised for allocation of development funding. Existing initiatives such as the national counselling in primary care, CIPC, service have received €7.5 million for further development from the programme for Government investment in mental health since 2012. This service provides short-term counselling for adults with non-complex psychological problems aged 18 years and over who hold a valid medical card.

The Government is strongly committed to improving all aspects of mental health services, building on the additional ring-fenced funding of €160 million provided to modernise such services between 2012 and 2016. In this context, funding for mental health in 2016 will increase from the 2015 outturn of €785 million to a projected budget of €826 million. This amounts to an increase of €41 million, or 5.2%. I stress that the Government is committed to increasing funding in the mental health budget in each year of its term of office.

Mental health services in Carlow are arranged in accordance with A Vision for Change, the national policy document for mental health services. Services are delivered across the geographical location through a combination of acute inpatient and community-based facilities located throughout each extended catchment area. Access is also available to acute mental health services through the emergency department of St. Luke's General Hospital, Kilkenny, by way of the mental health liaison service which provides mental health assessment and support to the emergency department on request.

Child and adolescent mental health services, CAMHS, in Carlow are delivered through the Carlow-Kilkenny mental health service. The Carlow CAMHS team is consultant led and comprises a range of multidisciplinary health professionals who are experienced in working with children and teenagers with mental health difficulties. The primary referrer to the service is the family general practitioner.

Substance misuse services provided by the HSE and HSE-funded agencies are based in St. Dympna's Hospital, Carlow. Service provision includes counselling, outreach and community drug initiatives and clients can be self-referred to this service. In addition, a weekly drop-in clinic is held in St. Dympna's Hospital.

In addition to nationally provided services such as Console, the Carlow self-harm intervention service, SHIP, is a free, GP referral specialist counselling service for individuals aged 16 years and over who are experiencing suicidal ideation or the impulse to self-harm. I note Deputy Deering focused primarily on young people, including those aged under 16 years.

The Government has committed to providing sufficient resources at national and local level to ensure each region has a full range of mental health supports available. Deputy Deering's frustration with services in County Carlow is shared by most Deputies in their respective counties.

We have started at a very low base. It is important to note that while people are coming forward and more people are looking to avail of these services, this is putting an additional strain on a service that has been under pressure for some time, even with additional funding. In the mental health division in my area of Louth and Meath, while the mental health teams for young people have increased and we are now implementing A Vision for Change, gaps remain in the system and we have found it very difficult to hire the relevant staff to deal with issues and to ensure waiting lists do not get out of control or that children must wait longer than 12 months.

I am conscious of the difficulty in recruiting and retaining nurses in the mental health area, and for that reason I am happy to inform the Deputy that the HSE is reintroducing a one-year post registration programme in psychiatric nursing for nurses who are already registered in either the general intellectual disability or children's division of the register. This programme is being provided through the Nursing and Midwifery Board of Ireland and UCD and I hope it will start in August. This programme will provide a small number of places and can only make a small impact, but it is a start and I am committed to ensuring it is done.

If the Deputy feels there are other issues outside of recruitment and staffing that need to be addressed within the services of the county, I would be happy to visit his constituency to meet the teams there and to try to address the problems there.