Thursday, 16 September 2021
Ábhair Shaincheisteanna Tráthúla - Topical Issue Matters
Mental Health Services
I thank the Ceann Comhairle's office for picking this matter this evening and allowing me to be here. We have a central Midleton mental health centre. It was built in the 1970s. It is called the Owenacurra mental health centre. It provides mental health services, continuing care, mental health care and respite for people in a vast area. Last June, a decision was taken to close the centre. Some 19 residents are currently in the centre. We were told there would be moves to find alternative accommodation for these people. There is also a day centre, which facilitates between 40 and 60 people per week. It is also used as a respite centre for two people every two weeks. That is a very important service to the people of east Cork.
I have two big issues. First, I want the HSE and the Minister of State to tell me what the long-term plans are to replace this service. I do not think there are any at present. That is crucial. People do not want to lose this hugely important service. The second issue concerns the 19 residents. I accept this centre is not fit for purpose and is of its time, but it is the home for these people. Would the Minister of State like to be told tomorrow that he will be transported to Enniskillen or Cavan, away from his friends and what he knows and is familiar to him? People in this centre can walk down town. They are known around the town. They can walk into the shops and churches and are comfortable in their surroundings. If any of us were moved to a strange place, it would be difficult, but if you have mental health challenges, it is even more difficult.
I am calling on the Minister of State to pause the closure of this centre. It will be done on a phased basis. I know there are problems in the centre and that the building is not fit for purpose, but there is no immediate danger to anybody. It is just next door to the Garda station. The fire station is only a couple of hundred yards away. There is no danger to anybody. I want a pause.
There has been some communication with families and residents this week, even though this was announced last June. Residents and families are anxious. They need clarity. The social interaction is hugely important. It has been said to me that you could not get a better service. It is a community. These people are part of the community.
I would also like the Mental Health Commission to have a look at this and ask what the impact on people is if they are moved from their homes to a strange place far away. We have no clarity as to where people will go. I accept the bona fides of the people in the HSE. They are doing their best and I want to be supportive of the work they are doing. They are faced with a huge challenge. I ask that they pause this for a number of months until we have a clear plan with respect to what the long-term service will be in that area. It is not acceptable this service be closed down with no place to reopen a similar service. We need to look after the residents.
We passed the Assisted Decision-Making (Capacity) Act 2015, which means that people have a right to make their own decisions and that must be respected, regardless of their capacity. We need to bear that in mind. I ask the Minister of State to go back to the Minister of State, Deputy Butler, and ask her to ask the HSE to pause the closing of this. It is not ready and there is huge distress and upset in the area over this. The anxiety levels are high. These people have enduring mental health difficulties and it is wrong that this is happening at this time. There can be a better solution, which is what I want. I want time and space for that to be found.
I thank the Deputy for raising this important issue. The Minister of State with responsibility for mental health and older people, Deputy Butler, has been regularly liaising with the HSE on this very important matter, since it was announced. The HSE has affirmed that in the context of the closure of the centre, the needs and preferences of each resident are of paramount importance.
On 28 June, the HSE notified the Department of Health that the HSE's Cork-Kerry community healthcare organisation had taken the difficult decision to close the Owenacurra centre in Midleton as the building is not fit for purpose. Owenacurra is a long-term residential centre with 19 residents but it also accommodates a mental health day service. The Mental Health Commission, as regulator, had raised serious concerns about the centre and the HSE shares those concerns. HSE estates confirmed that the building is in very poor condition with major defects and is not fit for purpose. It was originally planned to refurbish the building but as work progressed on those plans it became clear that no matter what refurbishment took place, the building could not meet either building or commission standards.
The HSE's priority is the welfare of the 19 residents of the centre. It has confirmed that all of the residents have had their needs assessed so that they can be appropriately placed in accordance with their assessed needs. I understand meetings with the multidisciplinary team to discuss options and the wishes of each individual resident, with family where consent is provided, are ongoing and I understand that it is planned to complete the programme of meetings this week. The multidisciplinary team continues to have ongoing discussions with all residents and a key contact lead is available as a facilitator for residents, families and the team. Social work input has been increased, including support from a housing co-ordinator, and increased consultant input is also available. A member of the independent Irish Advocacy Network is part of the project steering group, in addition to a mental health service user family member and carer engagement representative, to ensure the residents and families continue to have independent supports available throughout the process. The process of engagement with the staff is also being progressed, informed by the terms of the public service stability agreement 2021-22, Building Momentum, and underpinned by the nationally agreed redeployment protocol. The HSE is reviewing what healthcare services are required in the Cork-Kerry area and if this site is suitable for the delivery of any of these services. The future of the entire site will be considered at a later stage. A suspended mental health day service is also located within the building and work is under way to identify an alternative location for this service, as close as possible to the current location. The Deputy highlighted that people with mental health challenges may be moved to a strange place and he wants me to bring these views back to the Minister of State. He has also asked that this decision be paused. I will bring his concerns to the Minister of State tomorrow and see if she and her team can address them directly with him.
I thank the Minister of State for his response and for his commitment to bring my views and the views of the people in the area, which are quite strong and quite worried, back to the Minister of State, Deputy Butler. This is in no way an attack on the HSE, the Minister of State, the Department or anyone else. We want to come up with a proper solution. That is why I am asking that this be paused. I am told that some of the residents have been advised that they may have to go into Cork city, Kanturk or Sarsfield Court, which is miles away. At the moment they are in a comfortable area. They are familiar with their surroundings, they can go down town and into the shops and pubs or the local church, which is very close by. People know them, greet them and make them feel welcome. They are integrated into the community. That is going to be ripped out now and that is not good enough at this stage.
The engagement about which the Minister of State spoke only started this week. That is a very short amount of time and people have been concerned all through the summer. I understand there is no immediate danger in the building whatsoever so that is why I am saying we should pause this and engage. There are some older people who I understand may be happy to go to nursing homes at this stage. That may be so but each of these people has to be engaged with, and have their families present if they so wish, and we have to respect their wishes in that regard to see what can be done here.
The other issue is that the overall service for the residents, the respite care, which was not mentioned in the Minister of State's briefing, and the day service will all be lost to a vast area. East Cork is the size of some small counties, going from Youghal right up to Cork city and beyond, and north of that as well. That will all be completely lost and there are no plans that I can see to replace those services at a time when we are all concerned about the impact of mental health, the growth of the challenges people face because of Covid and other concerns and the constant negative news we are getting through the media all the time that the world is doomed and we are all going to hell in a handcart. This is having a big impact on people. We need to do better. I again implore the Minister of State, and the HSE and others if they are listening, to pause this for a while. Let us get together and talk about it and let us do better.
I thank the Deputy again for raising these very important issues. Improving all aspects of mental health service delivery is a priority for the Minister of State, Deputy Butler, the Government as a whole and the HSE, in line with the national service plan for 2021. This includes continued collaboration between the relevant agencies to ensure that quality and standards in our mental health facilities are further improved in line with the best practices and recommendations. With regard to Owenacurra, the most important thing is the safety and welfare of the current residents. The HSE has a plan in place to close the centre on a phased basis and to keep clear and open channels of communication with the individuals residing in the centre and their support networks. The aim is to secure an appropriate alternative placement based on assessed needs and in line with the will and preference of each individual. I hope the HSE will achieve these aims in respect of Owenacurra. I have taken on board what the Deputy has said about trying to stand back and, between all the stakeholders, to pause this decision. He also said that consultation only happened in the last week. That is a very fair and reasonable point. I will bring the Deputy's views to the Minister of State and hopefully she can liaise and work with him and all the stakeholders to get a satisfactory outcome.