James Browne (Wexford, Fianna Fail)
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7. To ask the Minister for Health when the full allocation for mental health spending in 2019 will be drawn down; and if he will make a statement on the matter. [41185/19]

James Browne (Wexford, Fianna Fail)
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I tabled Question No. 7 on the Order Paper to the Minister.

Jim Daly (Cork South West, Fine Gael)
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Budget 2019 made allowance for an additional €55 million for mental health services. This comprised €20 million continuing cost in 2019 of developments initiated in 2018, combined with €35 million for further new developments. Since 2012, the mental health HSE budget has been increased by almost 40%.

This investment has enabled the HSE mental health services to progress initiatives outlined in the National Service Plan 2019. Initiatives such as e-mental health pilot programmes and clinical programmes in areas such as eating disorders and attention deficit hyperactivity disorder, ADHD, continue to be developed and implemented with this funding. Funding is also provided in 2019 to plan for the opening of the new national forensic mental hospital.

To date, the HSE has drawn down €30 million of the foregoing funding, and an application for a further €10 million is currently being processed. In addition, €3 million has been paid to Pobal for the community mental health fund.

The management of the remaining €12 million funding for 2019 will be agreed with the HSE in the coming weeks.

I reassure the Deputy that mental health continues to be a priority area for the Government. We recognise that mental health service users are often among the most vulnerable in society and, for this reason, in budget 2020 the Government maintained its commitment to mental health with an allocation of more than €1 billion.

James Browne (Wexford, Fianna Fail)
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A Mental Health Commission, MHC, report published this morning identifies long-term neglect of people with serious and enduring mental illness in the mental health system. It is another in a regular series of highly critical reports from the Mental Health Commission.

I was not surprised by the report. One of the most difficult and common situations I deal with is persons being released from the department of psychiatry without accommodation and without rehabilitation services who end up in a revolving door system where inevitably, a number of months later, they are back in the department of psychiatry - a type of patch them up and show-them-the-front-door approach.

We are in year 13 of a ten-year mental health strategy and yet barely over 50% of the recommended staff are in place and less than 10% for those with intellectual disabilities, with none in some regions.

Fianna Fáil, through the confidence and supply agreement, secured an additional €105 million for mental health. In budget 2019, €55 million was secured. It was secured previously in 2018. The Department of Health knew that funding was coming. The Minister signed a document to that effect. Some €25 million of that expenditure seems to have been withheld so far this year. This is unconscionable. What is the reason for this funding being unspent and where is the ministerial oversight?

Jim Daly (Cork South West, Fine Gael)
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I am not sure from where comes this €25 million being withheld by the Government from the HSE. I saw a tweet from Mental Health Reform to that effect yesterday.

James Browne (Wexford, Fianna Fail)
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A parliamentary reply.

Jim Daly (Cork South West, Fine Gael)
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The Government is not withholding €25 million from the HSE. The full €55 million that was an order of Government was made available to the HSE to spend. There is a process under which the Department releases the funding as it is needed. The Department does not merely throw the €55 million onto the table and say, "Spend that." It is released as it is being spent and that is the process to which the Deputy refers.

There is not an issue with withholding funding. Some of it relates to recurring expenditure and one-off expenditure.

A sum of €12 million remains to be spent. We still have two and a half months of the year to spend that. I am meeting the HSE and the Department of Health next week to further oversee the expenditure. When the Deputy referred to ministerial oversight, I have overseen the expenditure of that funding, and, indeed, of the entire €1 billion budget, over the past 12 months.

Regarding his issue about rehabilitation and the MHC report, I will refer to it in a later response.

James Browne (Wexford, Fianna Fail)
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Reference to the funding being withheld came in a parliamentary reply. It stated the funding was unspent. There was a year's preparation available to ensure that this funding would be spent.

The funding is desperately needed in mental health services throughout the country and there is no reason to fail to spend it. The Mental Health Act 2001, which was due to be updated years ago, has still not been updated. Unqualified consultants are practising in mental health - a practice condemned by the President of the High Court. The majority of mental health facilities remain unregulated as they do not come under the MHC's remit. Mental health services in St. Luke's were prosecuted this year, the first time ever a mental health facility had to be prosecuted. Suicide remains the greatest cause of death among those aged between 15 to 24. Primary care psychology is a disaster, with patients three years waiting in my county of Wexford. Anti-depressant prescription is increasing at an alarming rate. The expansion of the Jigsaw service has been held up. When I started here, the Tipperary unit was to be opened within a few months. Three and a half years later, it still has not, yet the Department cannot spend funding. In the Department where most Ministers for Finance seem to suffer from financial incontinence, we have a Minister of State with responsibility for mental health who seems to suffer from financial constipation.

Jim Daly (Cork South West, Fine Gael)
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Those one-liners might sound good but the reality is that for every challenge in the system, there are many successes.

11 o’clock

We have a budget of €1.026 billion this year, up from €711 million when the Government took office in 2012. It represents an increase of almost €400 million in the budget. We also have the refresh of A Vision for Change. In the year to date, we have seen a 20% reduction in the number of children waiting for child and adolescent mental health services, CAMHS. Today we launched a telephone line which will be used to provide an advisory service to direct people to the most appropriate service. It line went live today on World Mental Health Day. The tele-health pilot schemes for psychology and psychiatry services are up and running. We have introduced 134 assistant psychologists and psychiatrists to create a lower level of infrastructure, particularly for young people, which has reduced substantially the reliance on CAMHS as a specialist service. There are many successes in the mental health service. I acknowledge the roles of the HSE and the Department in bringing them about.