Darren O'Rourke (Meath East, Sinn Fein)
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I thank the Leas-Cheann Comhairle for selecting this issue for debate. I thank the Minister of State, Deputy Butler, for being here.

In many HSE documents we see the mantra the "right care", the "right place", the "right time". In County Meath it does not happen. We are aware that there is an intent in acute services to close the ICU and emergency department at Our Lady's Hospital, Navan. We are at the bottom of the list or very close to it for primary care and disability services, GP services or the head of population services, children's services, occupational therapy, physiotherapy, psychology services and on the topic we are to discuss today, namely, mental health services. I draw the Minister of State's attention to the vacancy for a suicide resource officer, for example. This post has been vacant for longer than other vacancies in any other part of the country, since February 2020. Also in this context, with day services we have a failure by the HSE to deliver appropriate physical space to deliver services. As a result, we do not have the services delivered. For those small number of people who are receiving services, they are stressed and anxious that the service will be cancelled at short notice. A huge swathe of people who otherwise would have received services are not getting those services. Active day hospital services are not happening, there is no group work, therapy or assessments. These services would have been dealing with 70 people a day, and it is not happening. We want to hear from the Minister of State what the plan is for the physical space and for the services.

Ruairí Ó Murchú (Louth, Sinn Fein)
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I thank the Minister of State for making herself available for this issue. We are talking about the day hospital services for mental health in Navan, which as Deputy O'Rourke has said, provided group therapy, individual therapy, assessments, and a clozapine clinic. Unfortunately, only part of this is happening at this point in time. Before March 2020, this was happening properly and was fully functional. The fact is that we did not have the same pressure then in Meath as those on the services at the department of psychiatry in Crosslanes, which is under severe pressure. Louth and Meath have very low provision of beds. I am led to believe that it is around 14.2 beds per 100,000 people. The State average is in the 20s and the EUROSTAT average in 2018 was 34 beds per hundred thousand. It is very far from the number in Germany which is 128 beds per 100,000 or in Belgium at 135 beds per 100,000 people. We do not have the service that is required.

I have particular issues around the protocols and resources for the Drogheda department of psychiatry at Crosslanes. We had a service that was working and, to a degree, was replacing the need for people to possibly go into hospital. This is not the case. We have had a building that was handed over for Covid around March 2020. It was sought back around August and a promise was made of a modular build. That modular build later became a block build and it was delivered late in 2021. There was a fire in the old part of the hospital and the two parts that have been given to mental health services are not fit for purpose. Electricity is not working and there is no heating. The clozapine clinic for people who are treatment resistant is operating as a clinic in the cold and they are incredibly worried.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputies for raising this very important issue today. On Deputy O'Rourke's comments, I will check out the situation with the suicide resource officer post vacancy since 2020, and I will revert back to the Deputy on that. I do not have any detail on that today.

In relation to Meath mental health services, the HSE provides a wide range of services for adults, children and adolescents, and older people. These services are provided in various locations and settings and include community outpatient services provided by community mental health multidisciplinary teams, and approved centres and day centres, including Navan mental health day centre.

In 2020, use of the Navan mental health day hospital was required by Navan general hospital for Covid-19 purposes. This requirement continued longer than expected, as the pandemic wore on, leaving Meath mental health services without a day hospital. A longer-term solution was identified, which saw the day hospital move into a block-build construction extension to Our Lady's Hospital, Navan. This opened in October 2021 in line with Covid-19 restrictions and was gradually returning to full capacity with face-to-face therapies and assessments being carried out. Unfortunately, on 27 December, a fire broke out in an adjoining area to the day hospital, which rendered the building unsafe for use. Remedial works for the fire damage have taken considerable time to address and full safety clearance remains outstanding, though I am assured by the HSE that the clearance is imminent and the day hospital will reopen as soon as possible.

I note that patients of Meath mental health services continue to receive support and intervention from their local community mental health team. Also available are our online and telehealth services, many of which are available 24-7. Yourmentalhealth.ieprovides an excellent information service and signposts to numerous NGO partners who provide specialist help on behalf of the HSE.

It is very disappointing that the centre has been closed, obviously because of Covid, and when it did manage to relocate and the service was up and running that this fire could have happened. There is more detail in the remainder of the script but as I understand that the Leas-Cheann Comhairle is under pressure for time, I will not read it into the record.

On bed capacity, we are currently carrying out a review of bed capacity throughout the whole country. Some 25% of our bed capacity is sourced from the private sector. This is never included in the figures that are used, which only show the public bed capacity. When this review is finalised it will provide great data for me to be able to see all over the country where there are issues.

Darren O'Rourke (Meath East, Sinn Fein)
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I thank the Minister of State for her reply. I will point to one line that the Minister of State did read into the record which is "I am assured by the HSE that the clearance is imminent and the day hospital will reopen as soon as possible". I ask the Minister of State to take a personal interest in that to ensure that it happens as quickly as possible and that the services returned to full capacity.

Ruairí Ó Murchú (Louth, Sinn Fein)
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I thank the Minister of State. We will all be very interested in the review around the bed capacity and where those weaknesses are that need to be addressed. As Deputy O'Rourke has said, there is a need for the Minister of State to take a look to ensure that the plan is for the day hospital to be provided with a sufficient amount of space to offer the services that are required, and so it means that we deal with the community care piece. We are also looking for day hospital services in Dundalk and Drogheda. This would mean we could have community capacity and it can alleviate the pressure on the acute hospitals, which we all accept are under pressure. Will the Minister of State give us an assurance that she is going to do the devil and all to make sure this happens?

Catherine Connolly (Galway West, Independent)
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I thank the Minister of State for her co-operation and she has a full two minutes remaining.

Mary Butler (Waterford, Fianna Fail)
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Not at all, I understand.

I know exactly where the two Deputies are coming from. Sharing the Vision, our new mental health policy, is all about support in the community including day hospitals, peer support, crisis cafes, which all play a hugely important role to allow people with mental health issues to live at home.

It was unfortunate, which is the only word I can use, that having been closed for so long due to Covid, when the service did reopen, a fire broke out in the adjoining area of the day hospital. This meant that the building was unsafe for use. Obviously, we were not in a position to put people into the day hospital then. I have visited day hospitals all over the country. They are very important and hugely supportive for people have mental health illness and challenges. I give both Deputies a commitment here today that I will keep a special eye on this to look at the time frame. All I want to do is have all of these facilities open to support people with their mental health.

The temporary closure of the Navan day hospital due to a fire outbreak is very unfortunate. It has impacted on our ability to provide the level of service we aspire to uphold. The Deputies will appreciate it was completely out of my control. The reduction in service has been difficult for individuals using the day hospital, but I assure the Deputies that every effort is being made. I am confident that services will resume fully in the near future. Go raibh maith agaibh. I will revert to the Deputies when I have more information.

Catherine Connolly (Galway West, Independent)
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I thank the Minister of State.