Eugene Murphy (Roscommon-Galway, Fianna Fail)
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I thank the Minister of State, Deputy Corcoran Kennedy, for taking this debate. I have been highlighting the need to fast-track the appointment of a child psychologist in north County Roscommon for a number of months. It was one of the main points that I raised with the Minister of State, Deputy Stanton, during a recent Oireachtas briefing for Members from Roscommon and Galway in light of the 36 Syrian children who will be seeking refuge in Ballaghaderreen in the coming weeks. An immediate appointment is also necessary for the children of County Roscommon who have been languishing on an ever-growing waiting list since last summer. I have tabled parliamentary questions on this matter and have had this matter listed for a Topical Issue debate. In recent days, the Department of Health has approved a replacement post and a panel is in place. This is welcome. The pressure paid off in the end. However, it is important that this vacancy be treated as a priority and filled as soon as possible.

Since many of the Syrian children coming to Ballaghaderreen will undoubtedly have suffered untold traumas, it is vital that the post be filled before they arrive in the first week of March. Thirty-six children will be included in the group of 82 Syrians. Of these, 13 are under four years of age, 19 are aged between five and 12 years and four are over 13 years of age. There is a child psychologist covering the south of the country, but none is covering the remainder. The child psychologist who was covering north Roscommon is on sick leave and the post has been vacant since before last summer.

Many Roscommon children are on the waiting list but are unable to access child psychological services. For example, a six year old boy was referred by his GP. After several weeks of phone calls, his parents finally received a call informing them that the psychologist looking after school-aged children had been on sick leave since last March and that a locumcould not be found. Officials could not say when the service would become available again, but they indicated that no children had been assessed since March and that the waiting list would be significant. The school decided that it would use the single assessment that it was allocated each year to secure services for the child. His school spent several weeks trying to find out when the assessment would take place, only to hear a few days before the Christmas break that no assessments would be offered to the school, as the psychologist was still on sick leave and no arrangements were being made for the post. The family is not asking for preferential treatment or to skip the queue. His parents just want to see him have access to the services that they contribute towards and that are supposed to be available in the public health care system.

Many of the Syrian children arriving in the county will have suffered a great deal of heartache and brutality. They will need the support of child psychological services. This issue must be addressed. While I welcome the panel's creation, we must fill the vacancy urgently for the young people of County Roscommon who desperately need this service. The list is growing. We must deal with that, as we do not want long lists in situations such as this one. The Minister of State will agree on the importance of having child psychological services.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I thank the Deputy for raising this important issue. I am advised by the HSE that there is a vacancy in the psychology service in Roscommon arising from an extended sick leave and that a replacement post has been approved. I understand that there is a basic grade psychology panel in place and that the vacancy is being treated as a priority and will be filled as soon as possible, taking account of the recruitment process.

Primary care services are usually the first point of contact for families seeking help. With appropriate information and training, GPs are best placed to recognise risk factors for mental health issues, provide treatment or advice where appropriate and refer to more appropriate services or specialist services when this is indicated. Issues of a mild to moderate degree benefit from intervention at primary care level. Many children and adolescents experience mild emotional difficulties, which are often transient and do not require specialist intervention, but require support from other services.

The HSE's national service plan provides €5 million to address psychology services in primary care. This allocation aims to support services to work more effectively through increased resources and the development of new ways of working both within primary care and between primary care and mental health services. Primary care and mental health divisions in the HSE prepared joint plans for a more integrated primary care-based psychology service to focus on providing better access and using a multidisciplinary and multi-method approach. The approach would address existing deficits and target areas of greatest need.

From the funding, the HSE proposes to provide more than 100 assistant psychologist posts to deliver rapid access, low-intensity psychological interventions for young people with mild to moderate mental health problems. That is currently being considered in the Department. In addition, 20 additional staff grade psychologists for children in geographical areas, where there are no or an inadequate numbers of posts in place, are currently being recruited.

The dedicated funding will also provide for the delivery a computerised cognitive behavioural therapy, cCBT, programme for young people. The additional posts will provide services to service users under 18 years of age to address those waiting for treatment in the mental health and primary care divisions, while the online resource will also be developed for adolescents with mild to moderate mental health presentations.

Resources are allocated to work towards ensuring there is a consistent baseline in terms of staffing across primary care services with the areas of greatest need being addressed in the first instance. Working in partnership with other service provision stakeholders, primary care psychology services will adopt a stepped care model of service provision in child and adolescent services. These services will include rapid assessment for all referrals, a single point of contact to the health care system for all non-crisis and non-complex emotional or behavioural referrals, and a continuum of care through integrated working with primary care and secondary care professionals and with community agencies. Service provision will be monitored and evaluated regularly to ensure the resources are providing the new model of stepped care provision for young people. The Deputy may rest assured that my Department, in conjunction with the HSE, will continue to closely monitor planned service improvements for this key care area.

Eugene Murphy (Roscommon-Galway, Fianna Fail)
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I acknowledge the Minister of State's response. I know her heart is in the right place and that she takes her brief seriously. Two parliamentary questions were tabled on one of the cases to which I referred and I will outline it. I was told that the case was referred to the primary care child and family service in May 2016. I was informed the psychologist for the area is on long-term leave and national HSE approval is awaited for the temporary backfill of the post but, unfortunately, until such time as this position is filled there are insufficient resources within psychology to cross cover for this vacancy. In other words, there is a shortage of money. The reply finished with the line: "I trust this information is of assistance to you."

The second reply to one of the cases raised indicated that the psychologist for this area is on long-term leave and the PCMG has approved this backfill. I was told that the situation is currently awaiting national HSE approval. The reality in the case of one of those families, which went to a private psychologist and paid significant money to have the child assessed, is that they were told their six-year old needs support because he is suffering from autism but nothing is available at the moment in Roscommon. Some time will be available in the school come September but the centre of excellence in Athenry which deals with autism cases has a two-year waiting list. We have significant problems within the system. I am sure the Minister of State will acknowledge that. I do not want children who are five, six or seven years old not being assessed, or even if they are assessed not getting the treatment for a long period. The Minister of State is aware of the case I have outlined. I urge her to give it her best shot and ensure a child psychologist is appointed to Roscommon because we need one currently.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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Deputy Eugene Murphy will be pleased the replacement post has finally been approved by the HSE and that finding a replacement is being treated as a matter of priority. I am told by the HSE that the intention is to fill the post as soon as possible. The Deputy will understand that I cannot comment on the specific cases he has raised but it is helpful to outline them.

In response to what the Deputy mentioned earlier in terms of the refugees coming to Ballaghaderreen, the Irish refugee protection programme was established by the Government in September 2015. The intention is to provide a safe haven for persons seeking international protection. A programme office has been established by the Department of Justice and Equality which will oversee the programme and support the work of the task force. One of the objectives of the structures is to ensure there is a co-ordinated approach to addressing the health care and support needs of the people arriving under the programme. A number of health-related initiatives are already in place to support refugees. In that context the Health Service Executive is working to assess the overall care needs of the group that is due to arrive in Ballaghaderreen, both at local level and with Tusla, and expects to put appropriate measures in place to address those needs. Attention to the provision of counselling and related psychological support services will form part of that approach. The Department will be kept informed on all progress as it happens.