Claire Kerrane (Roscommon-Galway, Sinn Fein)
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The Minister of State will know that the e-mental health hub in Castlerea was opened in June 2020 as a state-of-the-art, first-of-its-kind hub for mental health. This was to serve the western region as a psychiatry of later life day hospital and a child and adolescent mental health services, CAMHS, Connect, that is, to serve the needs of both young and old.

I first began asking questions in late 2020 on the staffing levels at the hub and the services that were available. One reply from the HSE on 7 December 2020 advised me that one post had been filled and it was at recruitment stage with three posts out of a total of 21 posts. After further questions and a number of meetings in 2021, it then became apparent – unbelievably so – that no funding had been provided at that point for 2021. This was not common knowledge until I raised it in the House on a number of occasions last year. At that point, in July 2021, the Minister of State made a funding announcement more than halfway through the year.

I have previously asked the Minister of State my first question and I hope that she will answer it today. Why was funding for the e-mental health hub not continued into 2021? Why did it take until July 2021 for an announcement to be made, given there were no posts in place, the vast majority were vacant and there were no services available? Almost two years on now from the opening, the latest information I have is that five posts out of the seven for the psychiatry of later life remain unfilled and there are three posts vacant for CAMHS Connect. I also hope the Minister of State will be able to tell me what services are being provided in the e-mental health hub today, if the psychiatry of later life day hospital is functioning, and if it is not, when it will be.

The Minister of State will know that before it became an e-mental health hub, this was the Rosalie home. It was a home to dementia patients and older people with dementia. They had been promised by a previous Government they would be allowed to see out their days in that home. That promise was reneged on. They were sent all over the place to different nursing homes. Their families were absolutely distraught. It was incredible how they, our most vulnerable citizens, were treated. It has been difficult to see that replaced and opened with great fanfare and not even funded by the HSE, particularly the psychiatry of later life given the importance of that service, especially in a county such as Roscommon where we have an older population. When it comes to health services, the people of Roscommon feel like the poor relation.

This, unfortunately, is yet another example of something state of the art and one of its kind that opened in Castlerea in Roscommon and not funded. Today, almost two years on, we still have posts that are vacant. There is no excuse for this. Had funding been put in place and continued into 2021 and there was a real effort made to fill those posts throughout last year rather than leaving it until more than midway through the year, we would not be in this position today. There are no guarantees we would. These are important services for young and old for the western region. If this is a state-of-the-art service, then it needs to be funded continually. We need to get the posts filled and we need to get those services in place. They are very important.

I had a message from a lady in Ballinasloe the other day. She just messaged me basically to query and raise the fact of the number of young people committing suicide. It is incredible. We need the supports there for young people and older people. We need them as quickly as possible. This should not have taken until now to get these posts filled. They should have been filled. I hope the Minister of State will be able to answer those questions.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this issue. The e-mental health project was launched by the Tánaiste in mid-2020. Two main elements were identified for development as part of the Castlerea hub: a CAMHS Connect telehealth service and CAMHS day hospital. In addition, a psychiatry of later life day hospital was also identified.

Work was progressed by the HSE through 2020, including capital works and initial recruitment of staff. This involved expenditure in the region of €400,000 for refurbishment and €400,000 for staff. The hub was further developed in 2021 in the context of overall funding allocated for mental health that year, including further recruitment of staff. For 2021, 14 posts are approved, with €1.4 million in revenue allocated. This is real money. It is there to hire staff and there was no ambiguity about that. For 2021, 14 posts are approved and it is expected to be fully staffed in 2022. It is the first of its kind nationally and will form the core of the new Castlerea mental health hub across HSE West.

In response to the Deputy's question, the CAMHS day hospital is operating on a seven-day basis and currently serves counties Mayo and Roscommon. The team is flexible and provides intensive home-based treatment and assertive outreach, as required, which has been very important over the past two years when we have had the challenges of Covid. Provision of evidence-informed psychological and talking therapies form the cornerstone of supports provided, which include family therapy, dialectical behaviour therapy, cognitive behavioural therapy and similar service approaches.

The HSE indicates that the latest position on the CAMHS Connect service and day hospital is that approval has been received at community healthcare organisation, CHO, level for the following posts: consultant psychiatrist, non-consultant hospital doctor, NCHD, advanced nurse practitioner, ANP, senior social worker, clinical nurse specialist, senior psychologist and senior occupational therapist. The consultant, NCHD, ANP, and senior social worker for this team have all been recruited and the remaining three posts are at an advanced stage of recruitment. This facility has core mental health staff and telepsychiatry facilities to enable remote consultations. This is essential for Roscommon, which has experienced significant difficulty in recruiting and retaining staff.

On the psychiatry of later life day hospital, an NCHD and a senior psychologist have been recruited. The remaining posts are going through the recruitment process at present and will be filled as soon as possible. These posts are for a consultant psychiatrist, advanced nurse practitioner, social worker, clinical nurse specialist and a senior occupational therapist. We have to point out that the HSE is experiencing challenges in recruiting staff across mental health and, more broadly and in fact, this is an international issue as well. All these positions are funded. The €1.4 million was allocated to put in place all these staff in the Castlerea hub.

The psychiatry of later life day hospital will provide medical, nursing, occupational therapy, social work and psychology services.

The aim is for the day hospital to be the new base for the team and to provide a service five days a week. It also aims to provide a service to Roscommon-north Galway and to provide separate programmes for those with functional mental health difficulties and those with dementia who attend on different days. On the broader front, the development of all aspects of our mental health services nationally remain a priority for me.

Claire Kerrane (Roscommon-Galway, Sinn Fein)
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I thank the Minister of State. She still has not answered the question, though. We deserve answers as to why funding was not continued into 2021. Funding was provided in 2020. The Minister of State said work was progressed by the HSE, including initial recruitment in 2020, but by 7 December one consultant had been recruited - just one. There was nothing significant in regard to work progressed at that time. The real question is why funding was allocated in 2020 for the recruitment of staff and was then gone in January 2021. That is the main question. We deserve answers as to why that happened. I appreciate there are posts outstanding and there are issues in regard to recruitment and retention. I acknowledge that. However, there was a long gap from January to July 2021 when there was no funding and the hub was simply sitting there. That is not good enough and I want to know why that happened. I also want to know if funding at the present level will continue annually into the future to ensure we do not see that happen again.

I am particularly concerned about the psychiatry of later life element. Two posts were filled last October. Five posts remain unfilled today and that is of concern. We need to see that element of the hub opened as soon as possible. I ask the Minister of State to look in particular at that psychiatry of later life element. The CAMHS part is important. There are three vacancies there. Given the role the Rosalie Home played in the community of Castlerea, that element of psychiatry of later life for our older people is very important.

Again I ask why funding was dropped or not continued into 2021. Why did it take until July last year for funding to be put in place when we had a state-of-the-art hub where no vacancies were filled and no services were available by the end of 2020? Why then stop the funding into 2021? That is the only question.

Mary Butler (Waterford, Fianna Fail)
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The Deputy is missing the point. Funding was not stopped. In 2020, €800,000 was allocated by my predecessor, former Deputy Daly, and the Tánaiste to develop the Castlerea hub. In 2021, we moved very quickly to put in place €1.4 million to allocate staff. It takes a while to put staff in place. This Castlerea hub is a fantastic hub and I am delighted to say I secured funding in this year's budget to continue the roll-out of telehealth hubs. We are going to see a further one in Cork and a further one in Limerick this year. Because of Covid-19 and the challenges with staffing in certain areas, it is important for young people to be able to access telehealth hubs.

I visited Castlerea before Christmas. I went along and met the staff that actually do exist and I spoke to them. On that particular day, young people availed of services. I visited the psychiatry of later life. There have been challenges with staffing, but psychiatry of later life is so important. Even in this year's budget I moved to get funding for three pilot sites to incorporate psychiatry of later life with integrated care programmes for older people, ICPOPs, that are being rolled out throughout the country.

The Castlerea hub is the cornerstone of how we are moving now in regard to care for young people, care for teenagers. It will be funded going forward. It pains me that it takes quite a while to get staff in place, especially when the posts are funded. Previously we would not have had the staff because we would not have been able to fund them. The funding is in place and the most important thing now is that we get on with that particular service and support all the young people and the older people who need mental health supports.