Michael Lowry (Tipperary, Independent)
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32. To ask the Minister for Health if a commitment will be given to prioritise increased funding for mental health services in County Tipperary and nationwide in budget 2021 to prevent the Covid-19 crisis from turning into a national mental health crisis (details supplied) [24045/20]

Michael Lowry (Tipperary, Independent)
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Will the Government give a commitment to prioritise increased funding for mental health services in Tipperary and nationwide in budget 2021? I ask that question in the context that, last week, the HSE head of operations said there has been a significant increase in referrals to mental health services as a result of Covid-19. As we know, mental health services were already overstretched before the pandemic, meaning services now need substantial investment if people are to get the mental health supports they need when they need them.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for his question. I will be engaging in detail with the Estimates process and seeking additional funding for all mental health services. The challenges of Covid and living with the virus have caused huge problems for those with mental health issues and challenges. In line with the programme for Government, promoting positive mental health and reducing the burden of illness can have benefits for everyone. Mental health service users are among the most vulnerable people in Ireland.

I know the Deputy has been a long-time advocate for mental health service users in Tipperary. As he knows, I have visited Tipperary on three occasions since I became Minister of State with responsibility for older people. I first met with Oireachtas Members. On a second occasion, I met again with Oireachtas Members and with different support groups in Tipperary which are trying to support people with mental health issues. On a third occasion, I visited South Tipperary General Hospital and stayed there for three hours. Further to that, I also visited St. Luke's Hospital in Kilkenny, including the department of psychiatry, to see the exact situation in regard to inpatient beds. People with mental health issues from south Tipperary who need inpatient supports go to St. Luke's in Kilkenny and those from north Tipperary, the Deputy’s own area, go to Ennis Hospital for those supports.

I am acutely aware of the challenges in the area and that the Deputy is very concerned there are no inpatient beds in Tipperary itself. However, I believe the bed capacity is there at Ennis and at St. Luke's. For example, last year, the capacity in the department of psychiatry in St. Luke's was at 85% for the whole year.

Michael Lowry (Tipperary, Independent)
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I appreciate and acknowledge the Minister of State's commitment to improving mental health services in Tipperary and all of us recognise that. The problem is whether she has a budget to deliver. I have no doubt the Minister of State is well meaning, but I remind her that Tipperary is a large county with a population of 160,000 people.

The distance from Lorrha at the northern end of the county to Carrick-on-Suir is 130 km. The mental health strategy and the policy enforced on Tipperary by the then Minister of State, Kathleen Lynch, deprived our patients of access to vital services. The people of the county who have mental health issues are at a disadvantage. The county is left without a single acute mental health bed. There are no proper respite mental health beds. Access to crucial services is split between Ennis and Kilkenny. The system has not worked for Tipperary. It is a failed policy. The neglect of our mental health patients is indefensible. The extent of the deficit in services is bordering on irresponsible. The Minister of State needs a budget to correct it.

Mary Butler (Waterford, Fianna Fail)
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I will refer to the budget first. Budget 2020 saw the Government continue its commitment to mental health by increasing funding by €39 million to €1.026 billion. This represents an increase of over €315 million or 45% since 2012. Admittedly, we have a long way to go, and I am very conscious of that. I have three priorities for Tipperary. My first priority and commitment is to have Jigsaw open in Thurles before Christmas. I have given that commitment and I will follow through on it. The second commitment I gave previously, and this is where the budget Estimates are involved, is to seek €2 million in those Estimates to redo the crisis house in Tipperary which I believe is not fit for purpose. Third, under Sharing the Vision I will task the national implementation monitoring committee with completing a review of mental health bed capacity throughout the country. There are major issues in the south east, not only in Tipperary. Waterford and Wexford have the same issues relating to capacity. The first thing I want the committee to look at is bed capacity, and then we will work from there.

Michael Lowry (Tipperary, Independent)
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The reality is that the mental health budget has remained at 6% of the overall health budget for many years. There are fewer staff working in mental health services than there were in 2008. In January 2020, there were 10,642 individuals waiting for 12 months or more on waiting lists. There were also 2,000 children and young people on the waiting lists. In regard to Tipperary, at a time when there are dramatically increased levels of stress, anxiety, depression, isolation and loneliness, the lack of access to mental health services is inexcusable. At a time of great vulnerability, mental health patients in Tipperary are reaching out to an empty space. The lack of access to professional care, guidance and support is unacceptable. It must be seen as a priority for the Minister of State and this Government.

Mary Butler (Waterford, Fianna Fail)
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When I visited the emergency department, ED, in South Tipperary General Hospital, I was delighted to meet the team operating there. All mental health patients attending the ED are triaged in accordance with assessed clinical need with the objective of referring them as soon as possible to the HSE mental health service when they are discharged from the ED. The ED has a 24-hour mental health nurse liaison service for mental health patients, seven days a week. This was put in place in 2012 when St. Michael's closed down. Many other areas in Ireland would love to have similar supports. I spoke at length to the mental health liaison nurse on duty, who is one of three who deliver this 24-hour service. We discussed many issues that were raised with me previously, including voluntary and involuntary admissions, transfer of service users, assessment and the department of psychiatry. There are two rooms dedicated for that purpose. One is for the nurses and the other is for the patient as soon as he or she enters the ED and has been triaged. I will give the commitment I gave previously, which is that I will continue to work with all Deputies in Tipperary to try to improve the mental health services there.