Maurice Quinlivan (Limerick City, Sinn Fein)
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I did not realise the Minister of State, Deputy Feighan, worked for the Department of Justice.

I welcome the pilot 24-7 multi-agency mental health de-escalation team, which I understand has been set up in my own city of Limerick. It is something I welcome and support. Unfortunately, like most of the country, in Limerick issues regarding mental health have increased over the course of the pandemic. One of the things that the pandemic has cruelly demonstrated is how woefully under-resourced our mental health services are. Mental health is as important is physical health. A mental health concern is as big an impediment to an active life as any physical injury, but like an injury, if the resources are not provided, a mental health challenge cannot be addressed.

In Limerick, we have seen the child and adolescent mental health services, CAMHS, become overwhelmed with referrals. On many occasions, voluntary organisations have stepped up and have done an incredible job in supporting those in need. While there are many groups that I do not have time to mention, I would like to particularly commend the work of volunteers at the Limerick Haven Hub, Limerick Suicide Watch and Limerick Treaty Suicide Prevention, who do fantastic work on a voluntary basis.

The recent budget presented an opportunity to address the underfunding of mental health services. It missed the mark. What we needed was real investment. Sinn Féin proposed an investment of €113 million, but the Government has offered the equivalent of a lick of paint when the whole structure needs investment. The final outcome of the failure to treat mental health issues is often, sadly, suicide. In my home county of Limerick, we have lost too many - often young - people to suicide. Too often, the sound of a helicopter over the River Shannon is a signal that, tragically, another life has been lost and another family has been devastated by suicide. As such, any project or scheme that can alleviate pressure on these organisations while delivering care to those who need it should be welcomed and supported. My understanding of this pilot scheme is that it will be a multi-agency scheme that will involve mental health professionals, paramedics and specially trained gardaí. If a person is experiencing a mental health issue locally, then a specially trained team will contact them, triage them, treat them, and bring them or refer them to appropriate services. The scheme was part of a motion on the mental health crisis put forward by my colleague, Deputy Ward.

Mark Ward (Dublin Mid West, Sinn Fein)
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I am delighted to have the opportunity to discuss this pilot project in Limerick for a multi-agency mental health de-escalation team. It is a mouthful, but it is a really welcome initiative. When I got the role of spokesperson on mental health, I said that I would work in a tangible real way in opposition. I will welcome initiatives that are good.

As was mentioned, the triage team contains mental health experts, members of An Garda Síochána and a paramedic. I first heard about this scheme in a pilot project that was rolled out in parts of Belfast by my mental health spokesperson counterpart in the North, Ms Órlaithí Flynn MLA. It was run between the hours of 7 p.m. and 7 a.m. on a Friday and Saturday in parts of Belfast for a year. The results speak for themselves. They were really good. The team had 193 referrals in that space of time. Of these, 94 referrals were face-to-face crisis de-escalation contacts. Out of these crisis de-escalation contacts, they managed to divert 131 people who would have had to attend emergency departments, which is most welcome. It took the pressure off an already-under strain hospital system. It also diverted 61 people from the judicial system. I spoke last week about how the gardaí are the gatekeepers for mental health. The pilot diverted 61 people who, on another day, could have found themselves being charged, despite the fact that they were mentally unwell, because they may or may not have broken the law. This crisis de-escalation team was able to meet, treat and triage them in the community and refer them to the appropriate services.

I am looking forward to hearing the Minister of State's response to the issue, because it is a welcome initiative.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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On behalf of the Minister for Justice, I would like to thank the Deputies for raising this matter today. The Deputies will be aware that the Garda Commissioner is responsible under the law for the management and administration of An Garda Síochána, including the training and deployment of Garda personnel. The Minister for Justice has no direct role in such decisions. However, the area of mental health in the justice sector has been a priority for the Minister, Deputy McEntee, so we are grateful for the opportunity to provide an update on this important initiative.

The establishment of crisis intervention units was recommended by the Commission on the Future of Policing in Ireland in its report published in 2018. Crisis intervention teams are a priority project under A Policing Service for our Future, the implementation plan for the recommendations of the commission. These will be specialist uniformed units that will work jointly with health professionals to provide a rapid and integrated 24-7 response to people with mental health issues. Crisis intervention teams have become a globally recognised model within contemporary policing for safely and effectively assisting people who experience mental health crises or related problems within the community. The crisis intervention team model promotes strong community partnerships among law enforcement, health professionals and appropriate follow-on support agencies.

Members of An Garda Síochána in the Limerick division are leading on the implementation of a pilot project that examines, designs and resources a 24-7 multi-agency approach to responding to mental health-related incidents. The Minister, Deputy McEntee, is grateful to them for their leadership on this important project. The assistant commissioner with responsibility for roads policing and community engagement is sponsoring this important project within An Garda Síochána while local Garda management in Limerick is engaged in the design, planning and eventual roll-out of the project. The Limerick crisis intervention team project is in the consultation phase and is scheduled for implementation in the third and fourth quarters of 2022. The intention is that the pilot project will involve a co-located response unit comprising a community psychiatric nurse working alongside front-line members of An Garda Síochána to respond to calls from anyone in crisis.

The project team has engaged with an academic research partner from the University of Limerick who will assist in evaluating the project over a two- to three-year period. This person will also assist the team with policy terminology and language in respect of vulnerability and eligibility criteria. A training programme is also being drafted. The learning from the pilot initiative in Limerick will be of enormous value in shaping a model for crisis intervention teams to be rolled out across the country and ensure that all people with mental health needs receive the support they deserve and are diverted from the criminal justice system whenever possible.

Maurice Quinlivan (Limerick City, Sinn Fein)
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I thank the Minister of State for his response. I really appreciate it. The only concern I have is with regard to the third and fourth quarter of 2022 and I hope it will be done sooner than this. People in Limerick, the Garda Síochána and people who will be involved in this will not be found wanting in delivering the service, which I genuinely believe will be a game changer for many people who find themselves vulnerable. As I mentioned earlier, the community responders include Limerick Suicide Watch, Limerick Treaty Suicide Prevention and the Haven Hub. Their job will be made easier. This initiative will divert people from having to go to the accident and emergency department in Limerick which, as the Minister of State knows, is well overcrowded. For years it has consistently had the highest number of people on trolleys.

This is a very welcome initiative. I believe it will work very well. It will save lives and that is what we are about. I hope that when people see something as positive as this working well in Limerick it will be rolled out throughout the State. I hope to God it will work well in Limerick. I believe it will if we get the resources and support. I imagine areas will be shouting for it once we get it up and running.

Mark Ward (Dublin Mid West, Sinn Fein)
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This is part of Sinn Féin policy. It was part of our alternative budget. It would cost €6.8 million to roll this out across each CHO throughout the State. I welcome the involvement of the University of Limerick. Research is very valuable. I read out statistics from the pilot rolled out in Belfast. We can see how invaluable the service was. The Minister of State mentioned diversion from the judiciary system. This is also invaluable. Last week, I spoke about how the prison system is failing people with mental health issues. This is a way to stop people going into the prison system in the first place. It has to be welcomed. How long will the pilot project be? The Minister of State mention two or three years with regard to the contribution of University of Limerick. Will the pilot project be for two or three years? Does the Minister of State expect it to be rolled out in other areas within these two or three years? This would be very welcome.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Deputies for raising this important initiative. The Deputies are aware of the recent publication of a report from the Mental Health Commission on access to mental health services for people in the criminal justice system. It references the crisis intervention team pilot project in Limerick. The Minister for Justice is grateful to the inspector of mental health services and the Inspector of Prisons for their work on this important issue. The publication of the report is very timely. We know the healthcare needs of vulnerable and sometimes seriously ill people who interact with the criminal justice system are complex and require whole-of-system consideration and priority action. It is widely acknowledged these people are too ill to be in prison as they require urgent medication and treatment. There is a vital need to put in place properly resourced and appropriately located systems of care for those vulnerable people in society. This is also acknowledged in the programme for Government commitment to the establishment of a high-level cross-departmental cross-agency task force to consider the mental health and addiction challenges of those in prison and primary care support on release.

The Deputies asked how long the pilot roll-out is. I do not have this information to hand. I will try to find out. The Limerick crisis intervention team is in consultation phase and is scheduled for implementation in the third and fourth quarters of next year. This is approximately six months from now. I will find out. I invite the Deputies to send an email to me or the Minister and we will try to get this detail for them. I do not have it to hand.