Peadar Tóibín (Meath West, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

The mental health service is a vital part of our society, a point with which nobody in the Chamber would disagree. Families and communities throughout the country have been visited by heartbreak and tragedy because of mental health issues and County Meath is no different in that respect. Before Christmas we witnessed tragedy when seven men died by suicide within ten days, leaving communities in Kildalkey, Athboy, Trim, Kells and Duleek in shock and grief over the period. As a society we need to start asking ourselves really serious questions about what is happening.

In many cases mental health issues are very difficult to resolve and it is not necessarily in our gift within the Chamber to do so. Nevertheless, some issues can be tackled by us. As a state, we need to ensure we tackle the socio-economic reasons which lead to some people suffering from mental health issues and believing suicide is the only answer. We can affect the way the health service treats and supports people suffering from mental health problems. Every county has a reason to complain, but County Meath is at the bottom of the ladder when it comes to the provision of resources.

I discovered recently that before Christmas there were 32 staff vacancies in the mental health service in counties Louth and Meath. The chief officer of the community healthcare organisation, CHO, for counties Louth and Meath confirmed to me that the 32 vacancies were in a range of grades, including that of psychiatric nurse. It is an inordinately high number and extremely worrying that there is such a gap in the provision of key medical professionals in such an area of crisis. Last summer we found out that the child and adolescent mental health teams in counties Louth and Meath had just over half the staff they needed to fulfil their duties. In the midlands and counties Louth and Meath there are over 50 children waiting for over a year for their first appointment. The Minister of State must understand mental health matters are urgent and that those involved require support and treatment fast to ensure things will not deteriorate. This figure is the second highest in the State and has grown significantly in the past three years. This is not something the Government has inherited but rather a problem that has been created by its lack of ability, inaction and funding.

This is unacceptable and County Meath is an outlier of how bad things are in the country. Ireland is an outlier when it comes to how bad things are with respect to teenage suicides in the European Union. Ireland has the fourth highest rate. In September the HSE confirmed to me that the spend on mental health services in counties Louth and Meath was the second lowest per capitain the State, at €121.67. It is not hard to join the dots - when we invest so little and employ so few staff in an area, there will be high rates of suicide because of mental health problems. Every community has been affected by teenage suicide, but it is clear that the Government is either not equipped, unable or not sufficiently motivated to tackle the problem. Again, County Meath is at the bottom of the resources list. We need to ensure radical investment of resources and energy by the Government in order that it can start to tackle this problem in counties such as Meath.

John Halligan (Waterford, Independent)
Link to this: Individually | In context | Oireachtas source

I apologise on behalf of the Minister of State with responsibility for mental health issues, Deputy Jim Daly. I thank the Deputy for raising this very important and serious matter.

In the recent budget an additional €55 million was provided to progress new developments in mental health services this year. It brings overall Health Service Executive, HSE, mental health service funding to nearly €1 billion in 2019. This, in turn, will allow for continued improvements in all aspects of mental health care across the nine HSE community healthcare organisations, including CHO 8 which incorporates County Meath. Louth and Meath mental health services continue to strive to improve the level and quality of service being delivered and the environs in which it is delivered. The service supports clients in their recovery and rehabilitation as close to their home and community as possible. All of this is being done within the resources available. Referral to community psychiatric services is through general practitioners.

There is a range of care options provided by the mental health service for the population of County Meath. Acute inpatient beds for counties Louth and Meath are located in the department of psychiatry at Crosslanes in Drogheda. Referral for assessment is either through a GP or an emergency department. With regard tp community adult outpatient services, three teams are based in An Táin and cover Navan, Kells and Trim, and one is in Ashbourne. The psychiatric day hospital service covers Navan hospital and Ashbourne primary care centre. Examples of services provided from the day hospital include stress management, cognitive behavioural therapy, family therapy, alcohol counselling and a Clozaril clinic. Therapeutic interventions in line with national clinical care programmes are also being delivered, including, for example, for first episode psychosis and eating disorders. A first episode psychosis team is being established.

The day hospital provides an enhanced package of care for clients in the community, all of which is in line with A Vision for Change. A community high support residence is based at Ráth na Riogh, Leighsbrook Lane, Navan. There is an assertive outreach team for County Meath which provides continuing support for clients in their own community. The team is moving to a seven-day service. In addition, a home-based treatment team provides support for acutely unwell patients in their own home. Other services available to the population of County Meath include the psychiatry of old age team based on Kennedy Road, Navan, while there is an advanced technology room for persons with dementia. The child and adolescent mental health service is located in Hazel House, Navan and Trim primary care centre.

The recently agreed HSE service plan for 2019 outlines the priorities and actions to enhance mental health care nationally this year. This relates also to CHO 8 and County Meath and encompasses a range of services covering acute or community-based child and adolescent mental health services, general adult services and psychiatry of late life. The service plan also acknowledges widely accepted challenges in developing services, including increasing demands and difficulties in staff recruitment and retention, but the objective for the Minister and the HSE is to deliver overall service improvements this year.

Peadar Tóibín (Meath West, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

There is no doubt that there are good people doing good work in County Meath, for which we applaud them, but they are dealing with a tsunami of need. A Vision for Change is really important, but if we do not have the funds we meed for change, it is not worth the paper on which it is written. In County Meath we have three Ministers or Ministers of State in various guises, as well as two Fianna Fáil backbenchers, but we are not getting the funding we need. County Meath remains an outlier because of the number of vacancies in critical health care service grades. It is also an outlier because of the lack of funding.

Does the Minister of State not agree that it is really hard for these healthcare professionals to function and carry out their job regarding the level of need they face if they do not have the adequate resources to do so? Given the current state of the economy, the State has an opportunity to intervene in so many individuals' lives, to bring people back to good mental health and to ensure they do not end up thinking that suicide is some kind of solution to their situation. However, we can only do this if we have feet on the ground and the funds available for them to do their job. Despite the rhetoric we hear year after year, the figures are getting worse. I looked at the figures recently. The rate of self-harm in 2016 was 10% higher than it was in 2007, the year before the economic recession. The rate was highest among the young. One third of children's mental health beds in the country are closed at present due to staff shortages in child and adolescent mental health units. There are vacancies for psychiatric nurses while 52 children have been waiting more than a year for an assessment for child and adolescent mental health services. If we must tell a child not to come near us for 12 months before we will even talk to him or her regarding mental health services, we are failing those children radically.

John Halligan (Waterford, Independent)
Link to this: Individually | In context | Oireachtas source

The Minister of State, Deputy Jim Daly, wishes to reiterates that improving all aspects of policies and services for promoting positive mental health is a priority under the HSE service plan for 2019. The Deputy will be aware that the Minister of State has met him in the past regarding this issue. In addition, within the past few days, the Minister of State's office has been in touch about arranging another meeting with the Deputy in the near future. If the Deputy needs to bring all relevant local representatives to that meeting, that would be fine. This meeting would review mental health services in Meath. As the Minister of State asked me to tell the Deputy that this meeting will take place as quickly as possible, perhaps the Deputy could contact the Minister of State's office. The Minister of State continually liaises with the HSE to monitor all aspects of mental healthcare, including implementing new initiatives agreed under the executive's service plan. The recent budget provided an extra €55 million to progress new developments in mental health, which adds up to exceptional funding in 2019 at just over €1 billion. The construction of the national forensic mental health complex in Portrane is progressing with the facility due to open in 2020. All aspects of CAMHS nationally are being improved by the HSE to reduce waiting lists, although I know there are difficulties. The Deputy's points are well made and well taken. I met the Minister of State yesterday to discuss them and he told me that he would be glad to meet the Deputy and representatives, that is, whoever represents the mental health community in that area. That meeting will take place as soon as possible.