Dáil debates
Wednesday, 6 March 2019
Saincheisteanna Tráthúla - Topical Issue Debate
Mental Health Services Provision
1:10 pm
Eoin Ó Broin (Dublin Mid West, Sinn Fein)
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Families and service users in Clondalkin, Lucan and the surrounding areas have received some very bad news in recent weeks. One such piece of news concerns the potential moving of the HSE's adult community mental health team from Clondalkin to Tallaght due to difficulties with the current premises, and the second is the proposal to merge the young persons' mental health support service, Jigsaw, which would result in the loss of that service to its current base of north Clondalkin. It is proposed that the service move to Tallaght.
The Clondalkin drug and alcohol task force has written to all of the Deputies in the constituency to raise several concerns. In terms of the adult mental health team, it has said:
The removal of front line services, even on a temporary basis, to a location outside of the community will increase the barriers for those already faced with adversity to access services. As it stands, the taskforce says, the community mental health team are already under-resourced and work with the most hard to reach service user group who require ongoing support to address their mental health needs.
On Jigsaw, the task force has said: "The removal of services in an area where there are significant issues in terms of mental health for young people and adults, which is supported by research from the National Suicide Research Foundation and the National Office of Suicide Prevention, would have catastrophic implications for the community." The task force is urging the Minister of State to work with the four local Deputies in the first instance to ensure that neither of these services are lost to the local community and that Jigsaw retains a permanent base in north Clondalkin to provide the services for the surrounding areas. North Clondalkin in particular, because of a range of factors, has a significantly higher level of suicide and mental health issues for younger people than many other parts of the country. Jigsaw is one of the most wonderful services imaginable. I am sure the Minister of State has been in Jigsaw services in other locations. It is accessible to young people in the local area and has built up a reputation of trust and confidentiality. People can just walk in. They do not have to be referred by a GP or other formal services. In fact, even Deputies and members of the community can make referrals. There is a strong view among people working in mental health services and in the local community that the loss of these two crucial adult and young person facilities will not just mean a loss of services but could also result in the loss of lives due to the inability of people to access crucial mental health supports.
In the first instance I am urging the Minister of State to outline what his Department can do to ensure that these services are not lost to Tallaght. I also ask him to meet a cross-party delegation of the Deputies from the constituency to help ensure that, into 2019 and 2020, both services remain in the local community where they are needed and where they belong.
Jim Daly (Cork South West, Fine Gael)
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Some of the significant new funding provided by the Government for the key mental health care programme this year will be used to enhance prevention and early intervention services, such as the Jigsaw model of care. The HSE, in the context of its agreed service plan 2019, and arising from a recent evaluation of Jigsaw nationally, is considering in detail decisions around possible new Jigsaw sites over this year and next.
The HSE has informed me that a decision was taken in late 2018 to integrate services in Tallaght and Clondalkin under a single management structure. Importantly, however, there is no intention to reduce the number of front-line staff. The intention is to make the service more stable, sustainable, flexible and accessible to young people. Any inference or misinformation about the service being reduced or taken away is inaccurate and is indeed quite unhelpful in that it may cause uncertainty for young people and their families or those considering reaching out.
The main hub for the integrated service will be a new, larger premises in Tallaght. Jigsaw will still operate from the existing hub in Clondalkin for at least the remainder of this year, after which it will be looking at other premises or co-location options so that it ensures both a presence and accessibility across the full catchment area. Jigsaw has moved to reassure everyone involved by putting out “business as usual” messages on its social media. Jigsaw has also provided certain reassurances to local community agencies and to elected representatives.
The service, currently based on Moorefield Avenue in Clondalkin, is not closing. Jigsaw is currently exploring options for service delivery into south County Dublin around their new premises in Tallaght for this service from 2020 and beyond. It remains fully committed to the young people of Clondalkin and surrounding areas and will continue to deliver mental health services to them and their families. Any decision to change the physical location of the service will be made in line with Jigsaw’s desire to continue to offer the best it can to the people of Clondalkin and surrounding areas. The new premises in Tallaght will bring together the Jigsaw Clondalkin and Jigsaw Tallaght teams, thus creating one larger, more resilient team to ensure stability and sustainability into the long term for the service to the county.
In line with trends across Jigsaw’s network, the last twelve months have seen a 15% surge in demand for its services in Dublin south west. Jigsaw will continue to be responsive to this demand to the best of its ability. What Jigsaw will offer to the community in Clondalkin will actually expand, not contract, with a choice of locations for appointments - either Tallaght or Clondalkin - from now until the end of the year. There will be an e-mental health platform available from April to young parents, adults and professionals working with young people, and a new, integrated schools programme will be rolled out across the area from next September. There will be no reduction in their day-to-day work with young people and the community across Clondalkin, Lucan, Newcastle and Palmerstown.
Eoin Ó Broin (Dublin Mid West, Sinn Fein)
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Anybody who is raising this issue, whether on the ground in the community or in this House, is doing so because he or she wants to ensure that the community continues to enjoy the services it rightly deserves. It is unfortunate to use the word "unhelpful" and suggest that those of us who are raising it are doing so for reasons other than a desire to ensure our community has those services. The people on the front line and the families who are accessing Jigsaw services have asked us to raise this matter. If there is confusion, it lies in the Minister of State's own answer. He has not provided any clarity as to whether there will still be a Jigsaw office and staff based in the Clondalkin, Lucan, Newcastle and Palmerstown area after 2020. If there is not, there will be a reduction in service for people in that area. The Minister of State should not listen to me, but rather the people who use these services.
Susan Doyle tragically lost her 17 year old son, Robert Hoey, in 2011 to suicide. She went on to campaign for services, including Jigsaw, to be brought to north Clondalkin, where she lives. She is trained as and works as a suicide intervention and prevention officer. She is a woman with considerable experience. She said:
If people are not available in the community who are trained up people's lives are going to be lost again by suicide and people are going to suffer again because the help is not there in the area. It is vital that those services are kept in the area.
Tallaght is a considerable distance away, particularly for people who are experiencing significant mental health issues. Staff based in Tallaght will not be available to the same extent as the staff based permanently in the Jigsaw premises in Moorefield in north Clondalkin. Will the Minister of State give a commitment that Jigsaw will continue to have a permanent base in the Clondalkin area, rather than provide an outreach service from Tallaght? If he cannot give that commitment, will he meet a cross-party delegation of Deputies from the constituency to work with us to ensure the services our community so desperately needs will remain in it in order that young people's lives will not be tragically lost because of a decision to move services to Tallagh which is some distance away?
1:20 pm
Jim Daly (Cork South West, Fine Gael)
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Let me again be absolutely clear. The Deputy is perfectly entitled to raise any concern he has about any aspect of the mental health service that is within my remit for as long as I am in this position. He does not have to ask if I will meet him; of course, I will always meet Oireachtas Members. I cannot give a guarantee to meet every individual in the country who wants to meet me, but if Oireachtas Members wish to meet me, there will never be any issue.
On the wider issue, I am not accusing anybody of being reckless. We want to be clear in the interests of everybody. When a story gains legs, people begin to fear things when there is no need to fear. The Deputy knows that the budget for mental health services is €1 billion, with an additional €55 million being allocated this year alone for new initiatives. Since becoming Minister of State my focus has been on supporting and enhancing mental health services such as Jigsaw. They are the real winners. We are trying to move people away from the specialist upper-end services. For that reason, in the past 12 months we put 114 assistant psychologists to work in the community, with 20 psychologists and ten advanced nurse practitioners for young people. That is having a sizeable impact in reducing the child and adolescent mental health services waiting list.
Will there be a service in Clondalkin? The HSE has advised me that there absolutely will be. There are management changes and staff may be discommoded. I do not know, but that is not a concern I am picking up at this point. The service will be available in Clondalkin until the end of the year. Next year we will look at possible co-location in premises in Clondalkin, but we absolutely intend to maintain a service in Clondalkin. However, there are staffing changes to build a complement, critical mass, and have staff working together under a single tier of management. That is a better and more efficient use of our managerial resources and will ensure there will be more front-line services available for young people in the Deputy's area.
Recently I was in the very impressive Village Counselling Service where some exceptional work is being done. I am a huge promoter of working from the ground up within the community and lower level intervention, rather than escalating to the higher level. I hope I have provided the assurance sought by the Deputy.