Wednesday, 18 December 2019
Saincheisteanna Tráthúla - Topical Issue Debate
Mental Health Services Provision
Jigsaw has operated youth mental health services in Moorfield, Clondalkin, for several years. The services are well regarded in the community and those who have availed of them speak highly of them. This year, unfortunately, we learned that Jigsaw in Clondalkin is to relocate with Jigsaw in Tallaght, based in a new premises there. In discussions with my colleagues, Deputies Ó Broin and Gino Kenny, and the Minister of State, Deputy Jim Daly, and Jigsaw, we were guaranteed there would remain a substantial outreach service for north Clondalkin. The service has been widely availed of and there is great demand for it.
Unfortunately, however, the director of services at Jigsaw stated this week that the Clondalkin service was to relocate to a new premises at the end of the week and that outreach services have not been secured. She went on to state that, therefore, there is now likely to be an interim period during which all appointments will take place in Tallaght. That is not acceptable or workable. We have been promised, and as a community we expect, a substantial outreach service to continue in north Clondalkin.
It has been nine months since Deputies from Dublin Mid-West first raised the issue of Jigsaw's youth mental health services in Clondalkin and their possible closure. Since then, we have had two meetings with the Minister of State, Deputy Daly, and three with senior clinical staff at Jigsaw, we have engaged with the wider community, and there was a successful community vigil, all of which were about ensuring there would be a physical presence for Jigsaw in Clondalkin and the wider Dublin Mid-West area.
In recent months, we believed there was a solution. There was the possibility of co-locating Jigsaw with one or two other services, and negotiations were under way. As Deputy Curran noted, we learned on Monday of this week that the options have not proved successful and that from next week there will be no physical presence for this vital mental health service for young people in the constituency. The Jigsaw lease on the current premises will not expire until April and there is still time to resolve the issue. We ask the Minister of State, Deputy Daly, to intervene directly to ensure that every effort is made between now and April to maintain a physical presence of Jigsaw services for young people in Clondalkin.
Jigsaw's statement earlier in the week was very disappointing, to say the least. It would be an understatement to say that the matter has been handled very poorly by Jigsaw management since it arose. It is a question of maintaining mental health provision in north Clondalkin and the wider Dublin Mid-West. If the Jigsaw service in the area falls through, Dublin Mid-West, including Clondalkin and Rathcoole, will not have any mental health service provision, which will be a bad day for young people in the area.
We call on the Minister of State, Deputy Daly, to intervene, given that 84% of Jigsaw's funding comes from the HSE. That is a great deal of money, yet it has made a decision that is good for the centre rather than for young people. The decision is deeply regrettable.
Jigsaw in Clondalkin offers a free and confidential mental health support service for people in Clondalkin, Lucan, Newcastle and the surrounding areas in Dublin Mid-West. The service, with which I am personally familiar, was born out of necessity following a spate of youth suicides, not least in north Clondalkin. I have been accused in the past of taking the issue personally, which I do. Many of the young people who have died were children of friends and neighbours of mine. One such person, to whom I spoke on the phone before I came to the Chamber, is Susan Doyle, whose son, Robert, passed away by suicide. Susan reiterated to me her belief that her son, Robert, would still be alive today if a service such as Jigsaw had been available to him when he needed it most. If there is another youth suicide in Clondalkin or Lucan after the service is removed from the area, we will be left to ask ourselves whether the person would still be alive if Jigsaw had maintained the level of service it now has. The decision is a direct attack on the young people of Clondalkin. I urge the Minister of State, Deputy Daly, in the strongest way possible, to intervene.
I thank the Deputies for raising this important issue. I also welcome Deputy Ward to the House, given that it is my first time responding to him in the Chamber, and congratulate him. It is a great honour and privilege to be elected to the House for the first time and to represent one's community, and it is appropriate that he spoke on this important issue.
Mental health continues to be a priority for the Government and we recognise that mental health service users are among the most vulnerable in society. Accordingly, €39 million has been added to the mental health services budget for 2020, increasing the annual allocation to €1.026 billion. This represents an increase of €315 million, or 45%, since 2012. The funding has helped to enhance prevention and early intervention services such as Jigsaw. As part of this, funding has been provided to open new Jigsaw sites next year in counties Tipperary and Wicklow. The HSE has provided approximately €10 million this year to support Jigsaw services nationally.
The HSE has indicated that a decision was taken in 2018 to integrate services in Tallaght and Clondalkin under one management structure. There is no intention to reduce the number of front-line staff. The objective is to make the service more sustainable, flexible and accessible to young people throughout south-west Dublin. Any suggestion that the service will be withdrawn in Clondalkin is unhelpful and may cause uncertainty for young people and their families. The main hub for the improved service will be a new, larger premises in Tallaght. The main base of the Jigsaw Dublin south-west team will move at the end of the week to the new, bespoke premises in Tallaght. The plan was communicated at local level several months ago. It is intended that Jigsaw will continue to use the Moorfield premises for the next few months. Appointments for young people will continue to take place there, after the move date, to complete their therapeutic intervention with minimal disruption. Jigsaw is considering other premises and co-location options in order that it can ensure a presence and accessibility for the entire catchment area, and it has moved to reassure everyone who avails of the service by posting "business as usual" messages on its social media.
Jigsaw's commitment to long-term service delivery in Clondalkin, which it has given in writing to the local Deputies, remains firm. It has sought the Deputies' support to help identify and secure a suitable location. Jigsaw is actively pursuing two options for premises, co-located with other agencies, that will enable clinicians to deliver appointments to young people in Clondalkin. It is hoped that one of the options will come to fruition to continue service delivery in Clondalkin with minimal delay. In line with trends among Jigsaw's network, there was a 15% surge in demand for its services in south-west Dublin last year. Jigsaw will continue to be responsive to this demand to the best of its ability. There will be no reduction in its day-to-day work with young people or the community throughout Clondalkin, Lucan, Newcastle and Palmerstown. The Minister of State, Deputy Daly, the HSE and Jigsaw have been in regular contact with all the local Deputies in recent months, with the most recent meeting held on 2 October. Jigsaw subsequently met Deputies on 23 October and sent them a written update on 7 November. Of course, I will convey the issues raised by the Deputies to the Minister of State, Deputy Daly.
Let us get straight to the point. We are not creating any uncertainty. The director of services at Jigsaw stated there is likely to be an interim period during which all appointments will take place in Tallaght. While the Minister of State said the service will be available to young people from Clondalkin, Lucan, Palmerstown and so on, it will not be based in Clondalkin, which is the concern. As for the point that alternative premises are being sought, a cost is involved and I do not believe that Jigsaw has factored that in. It is important that it has the funding to maintain a physical presence in Clondalkin. The outreach service is not intended to bring people from Clondalkin and elsewhere to Tallaght. It is supposed to provide a local service.
It will not be business as usual if people cannot access the service at the location closest to where they live. In many cases, the young people in question are very vulnerable and are at risk of self-harm and suicide. The idea that accessing a service in Tallaght, where there is not even a direct bus service, would be business as usual is simply not the case.
We are pleading with the Minister of State to ask his colleague, the Minister of State, Deputy Daly, to intervene to reverse the decision to move the staff to Tallaght next week. Another three months, at least, should be provided for to allow the two other options that are on the table to be explored and to enable Clondalkin and the wider area of mid-west Dublin to retain the service that is so desperately needed by its young people.
If it were not for Jigsaw, which provides a great service in Dublin and across the country, many people would not be here at this time. This decision has been a bad one from the outset. It cannot be overturned without Government intervention. I reiterate that 84% of Jigsaw's funding comes from the Government. The Government has a say. It must override Jigsaw's decision to pull out of Clondalkin.
The reality is that it is not business as usual. When Jigsaw was providing a comprehensive service to the people of Clondalkin, Lucan, Palmerstown and Newcastle, it was business as usual. That comprehensive service is being ripped away. The hole in the youth mental health service provided to the people of this area will not be filled unless there is intervention. I urge the Minister of State to use all of his powers to intervene in this instance to ensure that the people of Clondalkin enjoy the service they are used to. It has saved many lives. As Deputy Gino Kenny has suggested, we are talking about Jigsaw because it provides a really good service. We will not know the damage caused by not having this service until it has gone. I urge the Minister of State to intervene as soon as possible.
I thank colleagues for raising important issues during this debate. I accept Deputy Curran's point about the need for a local-based service in Clondalkin. Deputy Ó Broin has asked me to talk the Minister of State, Deputy Daly. I assure him that I will do so. Deputy Gino Kenny mentioned that it was Jigsaw's decision to pull out of Clondalkin. He made the strong point that 84% of the money for Jigsaw is public money. We accept that it continues to provide a good service. Deputy Ward made the important point that we cannot allow a hole to develop in these services. We accept that Jigsaw has saved lives. The validity of the arguments is credible.
Deputies will appreciate that the HSE has a statutory responsibility for the planning and delivery of health and personal social care services at local level. In this case, the HSE and Jigsaw strive to deliver services in the best possible manner in line with the availability of resources and taking account of evolving service requirements. The Minister of State, Deputy Daly, has had several meetings with the HSE and Jigsaw recently to ensure local public representatives and other groups are kept apprised of the need to integrate Jigsaw's services in Clondalkin with other services in the wider south-west Dublin area. Deputies can rest assured that the Minister of State will continue to monitor this issue carefully. I will bring the valid arguments that have been made by Deputies during this debate to the attention of the Minister of State.