Martin Browne (Tipperary, Sinn Fein)
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I raise the issue of funding for voluntary mental health services in general. This week, within my constituency of Tipperary, one particular organisation raised concerns about its future due to funding shortfalls. I sent a letter to the Minister of State on a matter that concerned the CARMHA, or Connect And Recover from Mental Health and Addiction, organisation on Monday and thank her office for an acknowledgement. I hope my correspondence results in the Minister of State being able to contact the organisation and finding a way to get some sustainable funding for them.

Let me describe the CARMHA organisation, which is based in Nenagh. It provides free counselling and peer support services for addiction and mental health services, which is otherwise termed as dual diagnosis. The organisation was established in 2018 as a direct response to the unmet personal and community needs identified around addiction and mental health issues in rural Ireland. The service has been developed through a collaboration between addiction and mental health professionals, people with lived experience of addiction and mental health issues, family members and a group dedicated community workers. CARMHA provides its services in an integrated way and has a very successful track record. That track record is attested to by the fact that the service has catered for many referrals from the Probation Service, among other State agencies, since it has opened. This week, representatives of CARMHA took the step of going on Tipp FM to tell us that their funding is running so low that if things do not improve, the service will be closed by the new year.

I am aware that the Minister of State has said in previous correspondence that the Department of Health no longer provides any direct funding for organisations and that the HSE funds a range of service providers under either section 38 or section 39 of the Health Act. Before she tells me that I want to tell her that the organisation has been knocked back before. It previously had discussions with the HSE and was left with the distinct understanding that the services it provides do not fit the criteria for funding. When this is told to an organisation providing such an important service and that is as clearly committed to its purpose as is CARMHA, then it is not going to pack up and finish up. The organisation may be disheartened by the Department's response but it will still continue on because what it does matters. With the support of the public and some very kind donors it continues to provide for those who need them. CARMHA is now at the point where the Minister of State must intervene. I cannot overstate the urgency of this matter and the future of this service depends on her response.

The Minister of State must be aware that organisations such as CARMHA started up to address an unmet need. They made, and continue to make, a huge effort to help the people who need the services that they deliver in the surroundings that they provide. Will the Minister of State do something similar? Will she call CARMHA and find a way forward with it? Unless the organisation gets real support, then the people of Nenagh will lose a service that they have fully backed all along, the people who use this service will be severely impacted and the health services will have one less service on which to rely.

As Minister of State with responsibility for mental health, the Minister of State is in a unique position to at least assist CARMHA in sourcing the funding it needs so that it and, more importantly, the people who use its services, can have the certainty that the services it provides now will remain available and funded into the future. Otherwise, in the new year, the lack of sustained funding may cause CARMHA to close its doors for good, which would be a travesty for Nenagh and the people from further afield who use its services.

The Minister of State is in a unique position to help and do something special here. I urge her to act fast. I am aware, through an Teachta Mark Ward, that the additional €10 million announced for mental health provision, which must be spent by the end of the year, has still not be spent. Many community groups that applied have not heard anything back about their applications. I ask the Minister of State to explain that. Will community groups that receive funding by the end of the year be able to carry it over into next year? These groups, including CARMHA, need sustained funding to ensure the services they provide today will be available tomorrow and into the future.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this important matter. The continued enhancement and improvement of our mental health and suicide prevention services remains a priority for me. I was pleased, therefore, to secure unprecedented funding of €1.149 billion for HSE mental health next year. This is an increase of €47 million over 2021.

Next year's new development funding will provide for the recruitment of 350 new staff across mental health and will allow for new initiatives in community mental health teams, including CAMHS, out-of-hours supports, specialist eating disorder services and mental health services for older people. It will provide for dedicated funding to progress the national clinical programme on dual diagnosis for people with addiction and mental health difficulties, including the recruitment of staff in this particular area. The details of these new measures are being finalised as part of the HSE national service plan 2022, which will be published shortly.

A key approach of our new mental health policy, Sharing the Vision, is to improve access to all relevant services, including more integrated and person-centred care. Sharing the Vision recognises that people with a dual diagnosis should have access to appropriate mental health services and supports by addressing existing service gaps and developing stepped, integrated models of care. The national implementation and monitoring committee is tasked with driving and overseeing implementation of the policy's recommendations, including those relating to dual diagnosis. I am pleased to say it is progressing well in its work. Importantly, the dual diagnosis programme has a draft model of care, which takes account of service user views. It describes the clinical pathway for service users with substance misuse and moderate to severe mental health difficulties, with links to primary care substance misuse, community mental health and acute services. This is informed by international best practice and the experience of a national working group.

A national clinical lead and a programme manager for dual diagnosis have been appointed. They have quickly established a multidisciplinary working group to finalise the model of care and develop pilot sites to start the programme. HSE mid-west community healthcare is in the process of developing a dual diagnosis service and is establishing a national pilot site for this. This will be a consultant-led multidisciplinary team based in Limerick, with reach across the wider mid-west area, including north Tipperary. The multidisciplinary team will include peer workers and counsellors with specific expertise relating to mental health and addictions.

It is of note that the national drugs strategy, Reducing Harm Supporting Recovery, sets out the Government's strategy to address the harm caused by substance misuse in Ireland up to 2025. The Department of Health provides over €130 million to drug and alcohol services to support the strategy. In line with Sharing the Vision, there will be an enhanced focus moving forward on the development of tiered, integrated supports between primary care, addiction services and specialist mental health services to ensure the best possible outcomes for people with a dual diagnosis. The HSE already provides support for such work, where it aligns with the local objectives identified in the HSE service plan. This is done through a service level agreement for NGOs providing services to, or on behalf of, the HSE.

With respect to funding that is available for CARMHA, every organisation that wishes to apply for ongoing funding must make a business case to its local HSE community healthcare organisation, CHO, office. In the case of CARMHA, the relevant office is the CHO 3 office for north Tipperary. There is a process in place and service level agreements are arranged with many agencies. Criteria must be met, and the criteria are analysed. After all, taxpayers' money is at stake. There are over 1,000 voluntary organisations in the country. CARMHA must apply, through the local HSE CHO office, for funding to see if it can reach a service level agreement if its services are needed by the HSE.

Martin Browne (Tipperary, Sinn Fein)
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I appreciate where the Minister of State is coming from and that CARMHA has to apply for funding like other organisations. As I indicated earlier and in previous communications with the Minister of State, CARMHA has already applied for funding. What it and similar groups need is long-term funding to ensure their survival. Let us be honest, CARMHA and similar organisations are filling a gap and their services are needed because vital resources are missing in other areas. I ask the Minister of State to contact the organisation directly with a view to finding a solution so that it and other groups can continue to fill that gap.

As I said, the Probation Service and other services are sending people to CARMHA and similar organisations. The State itself is sending people to organisations like CARMHA because it knows there are gaps in the system. While I appreciate that public money is involved, I do not think the Minister of State will find anybody who will say that CARMHA does not provide value for money. Hundreds of people use the services it provides. If CARMHA and other groups have to close at Christmas or in the new year, it will put extra pressure on our health service. The Minister of State will be under pressure to provide more funding. Can some of the €10 million in funding be used to help these kinds of groups?

Deputy Kerrane completed a survey recently on the cost of living. Of more than 14,500 people who responded, 77% noted that the increased cost of living had a negative impact on their mental health. This is the kind of problem we are facing. Organisations such as CARMHA will be vital in trying to deal with that. I ask the Minister of State to pick up the phone and contact the organisation.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising the issue. I met representatives of CARMHA previously in Tipperary when I met many organisations. Addiction is a responsibility of the Minister of State, Deputy Feighan. With respect to available funding for organisations that provide support to those with mental health difficulties, every organisation that wishes to apply for ongoing funding must make a business case to its local HSE CHO office. In the Deputy's case, the relevant CHO is CHO 3. As I said, there is a process in place and criteria to be met. As Minister of State, it goes beyond my function to pick up the phone and tell the HSE or any community healthcare organisation to allocate funding to a particular organisation. There are different governance issues and criteria that must be met. These are clearly set out and any organisation can apply for funding.

I will be making an announcement at the end of week on how the €10 million will be spent. The matter is currently being finalised. Community groups, departments of psychiatry, various community homes and day-care centres for those with mental health issues will all benefit from it. I wanted to bring the needs of the service user to the fore in this. There has not been a call-out for voluntary groups yet, so Deputy Ward was misinformed. I explained that to him in the House last week. The call-out will be in January and will be overseen by Mental Health Ireland. Any organisation that is affiliated to Mental Health Ireland, of which there are over 1,000, can apply for funding in January following the call-out. There will be strict criteria in relation to governance, for example, requirements that applicant organisations have a bank account, chairman and secretary. These are the normal procedures that have to be followed when taxpayers' money is being spent. Details will emerge by the end of the week. All the organisations can apply for funding early in the new year.