Donna McGettigan (Clare, Sinn Fein)
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I thank the Leas-Cheann Comhairle and congratulate him on his position.

There are no dedicated public inpatient beds for adults with anorexia or other eating disorders in the mid-west region. Nationally, only three public inpatient beds exist for these patients, all of which are located at St. Vincent’s hospital in Dublin, serving local catchment areas. The HSE introduced a national model of care for eating disorders in 2018. This included the appointments of 16 specialist teams and 23 adult inpatient beds across the country. Only 11 of those specialised teams have since been established. This does not include the mid-west region.

In addressing this gap, the HSE has been purchasing inpatient beds from private units. Additionally, the treatment abroad scheme has been utilised since 2020.

In December I was contacted by a distressed mother of a very seriously ill 15-year-old daughter who is an anorexia patient with a history of self-harming. When she brought her daughter to UHL in December she found her daughter in bed covered in blood, having deeply severed her wrists and having left suicide letters. This young girl was discharged after two days under the care of CAMHS Ennis with a referral to the Galway adolescent mental health inpatient unit. However, at the time there was no bed for her. This is simply unacceptable.

Due to these shortages, individuals like this young girl who is a constituent of mine cannot access specialised inpatient care for eating disorders. As a result, some patients are forced to find treatment abroad through the HSE treatment abroad scheme, TAS. Between 2022 and 2024, the HSE spent more than €12.7 million to facilitate inpatient care for adult patients with eating disorders via this scheme. Yet, no funding has been provided over the past six years to solve this issue here and provide eating disorder treatment beds. Ireland has just three public beds in the entire country offering specialised treatment for these patients. What happened to the commitment by the Minister of State's Department to open 20 new beds by 2023? Patients impacted by eating disorders outside these catchment areas in Dublin are normally referred to general psychiatric units, where they often do not receive specialised care. A journal.ie report into this crisis gives some very stark figures in relation to this and noted that in 2022, there were 210 hospital admissions for eating disorders, the vast majority of whom were women. This was the highest level of admissions in a decade.

Last year, Sinn Féin spokesperson on mental health, Deputy Mark Ward, noted that the reports from the eating disorder charity Bodywhys state that the number of people presenting for treatment with eating disorders has increased over the past few years. In 2023, 4,809 people accessed support through the charity, which was a significant increase of 19.5% over the previous year. The HSE’s model of care, planned to modernise the country’s eating disorder services between 2018 and 2023, inclusive, did not receive any funding. Sinn Féin’s mental health spokesperson, Deputy Mark Ward, raised this issue before and we are still here asking why this has not been fulfilled. The HSE's 2025 national service plan states it plans to continue to roll out the national clinical programmes for ADHD for adults and eating disorders. I would like to ask the Minister of State how the Government is meant to achieve this with the severe lack of beds, let alone any sort of specialised treatment care. Will she provide us with an update on the recruitment process for consultant psychiatrists and dieticians please?

Mary Butler (Waterford, Fianna Fail)
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I thank the Leas-Cheann Comhairle and from the outset I congratulate him on his recent election to Leas-Cheann Comhairle. It is great to see him in the Chair.

I thank the Deputy for her forbearance. Last Thursday I was not in a position to take the question. I thank her for agreeing to have the debate tonight.

I thank the Deputy for raising this important matter in the House this evening. While I cannot discuss the details of an individual case here, I acknowledge what the Deputy has told me and am sorry to hear about this experience. As Deputies will be aware, eating disorders occur in approximately 5% of the population and have long been recognised as one of the most severe of the mental health conditions. We also know that it disproportionately affects adolescents and women. While some people benefit from more intensive treatment through day programmes or inpatient care, research shows the most effective treatment setting is in the community, and this has been the area of focus for recent new investment in eating disorder services. Some 90% of people with an eating disorder are being treated in the community. Enhancements for specialist mental health services such as the national clinical programme for eating disorders is a key priority for myself as Minister of State, the Government as a whole and the HSE.

Dedicated investment in eating disorders continues. Last year, the HSE spent over €9 million on eating disorder services under the clinical programmes. It is factually incorrect to say that money is not being spent. The previous year the spend was €8 million. It is ring-fenced funding that has been built on, year on year. Approximately 100 posts are funded under the programme including ten consultant psychiatrists now treating people with eating disorders across the country. The national clinical programme is being implemented by multidisciplinary teams on a phased basis. There are now 11 teams in place, as the Deputy said, six adult teams and five child and adolescent mental health services, CAMHS, teams. Funding was secured for an additional two teams under budget 2025. I also secured the funding for the 14th team last year when there was an announcement of €10 million last February. This means that 14 of the 16 teams envisaged under the model of care are now funded. It takes about a year and a half to stand up a multidisciplinary team. I am delighted to say that one of them, a CAMHS team, is on the way to the mid-west, in Limerick. These are very specialised services.

To stand up the team takes some time. It has to be led by a consultant psychiatrist. That means we will have a new CAMHS eating disorder team for the mid-west, bringing the total number of eating disorder teams nationally to 14 out the 16 teams under the model of care. In addition, HSE data indicates that, as the national clinical programme is rolled out, fewer people are needing to access eating disorder services abroad via the treatment abroad scheme. For example, I understand from the HSE that no child under 18 has had to be sent to the UK for treatment of an eating disorder since 2019. We have four different inpatient facilities for eating disorders for those under 18, namely, Eist Linn in Cork, Merlin Park in Galway and Linn Dara and St. Vincent's in Dublin.

I am also aware the HSE funds patients in private facilities based on individual clinical need, as assessed by the local mental health team, and the prioritisation of available funding. I will address the beds in my supplementary reply.

Donna McGettigan (Clare, Sinn Fein)
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While there has been a steady increase in the number of treatment hubs, there is still no funding for new inpatient beds. For people with eating disorders, it is usually for an extended period in an inpatient facility, which can be very difficult for the person. This treatment can be expensive and the process to get a bed can be so long that it means the person ends up needing more care.

The HSE spent more than €4 million sending seven people with eating disorders abroad for treatment in 2023. We need to stop sending extremely sick people abroad and put the much-needed money spent on the treatment abroad scheme into services here at home. People with eating disorders end up being referred to a general psychiatric unit, meaning they do not get the specialised care they need. Consistent funding is needed to provide much-needed beds, while more specialised teams are brought on board. It is a positive step in the right direction. Across the system, awareness and education has improved.

It is simply not enough. We need more investment and more beds now. However, I welcome a Limerick team coming into effect.

Mary Butler (Waterford, Fianna Fail)
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The new CAMHS eating disorder team will transform the experiences of adolescents with eating disorders in the mid-west, giving them earlier and enhanced supports and reducing the need for hospital admissions. As I said, there are currently 20 dedicated eating disorder beds across the four CAMHS inpatient units. The Deputy is right to say there are only three adult beds in St. Vincent's hospital. We have done a full bed capacity review of all mental health beds across the whole country.

I have asked the HSE to conduct a full review of the national clinical programme. When it was established in 2018, at the time there was an indication that there may be 60 people who might need access to eating disorder extensive supports. I am meeting the lead on eating disorders this week. Last year, the figures show there were 894 referrals. We have seen the issue regarding eating disorders grow exponentially over the past four to five years, especially among young girls aged 15 and 16 with anorexia nervosa. When the model was put in place in 2018, it was envisaged that the best care for young people like that is in the community. A decision was taken at the time to try and put supports across every single community. When I became a Minister of State in 2020, we had one eating disorder team in place. We will have 14 by the end of this year. I have built on it year on year, securing the funding and getting the multidisciplinary teams in place. We will do the next two teams next year, and that is the 16 under the model of care. Notwithstanding that, our focus has to turn to the beds. I would like to see a geographical spread of the beds, not just in the large cities. I met with my HSE officials last week to discuss it.