David Cullinane (Waterford, Sinn Fein)
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A number of weeks ago, I met representatives of Comhairle na nÓg who had travelled from Waterford to submit a petition they had carried out. They met the Minister of State the same day. I know she is aware of this issue. Waterford is the only city that does not have a Jigsaw service. I know the Minister of State would join me in supporting Jigsaw as an organisation for the wonderful work it does. It is really important that young people who have a mental health difficulty get every opportunity to get supports. Very often, the focus is on the acute side and the child and adolescent mental health services, CAMHS, which is obviously very important. However, if we can prevent a person developing an acute mental health illness and provide the full range of supports young people need, it would be best for everybody, particularly for the young people themselves. Comhairle na nÓg initiated its petition at the west Waterford food festival. It received more than 1,100 signatures. The group was blown away by the interest in this issue. I have met Jigsaw a number of times and I know that an application for funding and a detailed business case have to be made. It is my understanding that this has happened. Those are with the Minister of State. I assume there is also an issue with premises. That will also have to be sorted.

As I have said, Deputy Conor McGuinness and I met the representatives from Comhairle na nÓg. We are very happy to work with the Minister of State, with Jigsaw and with anybody else to get this over the line. I am hopeful that we can. It would be a fantastic addition to mental health services in Waterford, particularly for young people. I am hopeful that the Minister of State's response today will be a positive one that will support the application. If she is supportive, what timelines are we looking at to get the service operational and up and running in Waterford?

Conor McGuinness (Waterford, Sinn Fein)
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The Minister of State will agree it is unacceptable that Waterford is the only city, and the south-east region is the only part of the State, that does not have a Jigsaw youth mental health service. These services are not only physically based in premises but also offer outreach services. People I am dealing with right across Waterford city and county and also those in parts of south Tipperary, south Kilkenny and Wexford would be able to avail of this. There would be outreach services in towns like Dungarvan, Tallow, Kilmacthomas, New Ross and Clonmel. As Deputy Cullinane has mentioned, we very recently met Comhairle na nÓg. I know the group went on to meet the Minister of State afterwards. They presented to Deputy Cullinane and me, to the Minister of State herself and perhaps to the Minister of State, Deputy Cummins, a petition calling for this service to be initiated in Waterford. It is not just Comhairle na nÓg, although it has been driving this campaign. Parents are also saying it to us day in and day out. Practitioners in the mental health space and advocates across the city and county are calling for this and have been for many years. As Deputy Cullinane has said, early intervention is key. We know of the issues in CAMHS, which primarily revolve around recruitment and retention and the inability of children in need to get a foot in the door and that first appointment. Community-based early intervention is really important.

We are told that the HSE is important. As the Minister of State will know, I have submitted a parliamentary question on this every month since being elected. We know the HSE is broadly supportive. I know from the press that the Minister of State received an application at the start of May. The response I got from the HSE just last week did not mention that. It did not seem to be aware of it. Is there a breakdown in communication?

The other issue that is really important to raise and discuss here is the issue of a premises. What work has been done to engage with the local authority, HSE estates and other agencies or bodies that might have access to property in Waterford to find a home for a Jigsaw service?

Mary Butler (Waterford, Fianna Fail)
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I thank both Deputies for raising this really important issue today. I recently met Comhairle na nÓg to update the group on my efforts to establish a new youth mental health service for Waterford and the south east. I will give a big shout-out to Theo Hannigan, Mollie Mernagh and Eve Meleady, the three amazing young people who presented me with a petition with a lot of signatures. They are great young people and great ambassadors for their three schools: St. Paul's Community College, the Friary in Dungarvan and my own alma mater, St. Declan's Community College in Kilmacthomas.

Improving access to a range of youth mental health services is a priority for me, for the Department of Health and for the HSE. In recent weeks, I received a formal proposal from Jigsaw to establish a youth mental health service for Waterford and the south east. It is important to point out that Jigsaw changed its model of care in 2022, during the Covid pandemic. Its services to support young people now have 73% coverage across the country but 100% is covered online. I meet Dr. Joseph Duffy and his team regularly. Last year, we discussed moving back towards more physical structures but they are costly.

I have also invited proposals from other relevant national organisations that might be interested in developing youth mental health services. For example, there is a fantastic service under Mental Health Ireland called Mindspace Mayo that provides very similar supports. Work to secure a suitable premises for this service has begun with the chief executive of Waterford City and County Council, whom I thank for his interactions with me. I have discussed the need for the service with the local HSE integrated health area manager, who is very supportive. I am evaluating all the options available to me as Minister of State as to how best to provide a youth mental health service in Waterford and other identified areas of the country where a service has yet to be established, such as Kildare, Clare, Cavan and Monaghan. I intend to secure funding for this new early intervention youth mental health service in the Estimates process for budget 2026.

While CAMHS provides specialist supports for children, I am acutely aware that counselling supports are very important for young people, who deal with a lot of different issues including exam stress, anxiety, bullying and social media. The list is endless for many young people, especially for those young people in the LGBT+ community. Supports are vital. Young trans people can feel very isolated, alone and misunderstood. They face a great many challenges because they walk a different pathway in life. Counselling supports are vital. I want to compliment the great work of BeLonG To and ChillOUT, which are based at the Manor Youth Café in Waterford city every Sunday from 3 p.m. to 6 p.m. The programme for Government commits to ensuring a transgender healthcare service that is based on clinical evidence, respect, inclusiveness and compassion. I was happy to write that into the programme. I know the trans community very well. I am very proud to be the mother of a young trans man. I hope and pray that all Deputies can support this. I do not think it is too much to ask.

Foróige also has to be commended on the fantastic supports it provides to young people based in Ferrybank, Tramore, Portlaw and Carrick-on-Suir, all of which enhance the life chances of ten- to 18-year-olds. They are all really important supports. I will come back in with regard to other funding I am providing this year.

David Cullinane (Waterford, Sinn Fein)
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I agree with all of the points the Minister of State has made. As the father of a son who is doing the leaving certificate at the moment, I know about the stress that many young people face. I also agree with the Minister of State's comments regarding the LGBTI community, the trans community in particular, and the work being done by the various groups in Waterford. Obviously, people need mental health supports for a whole range of reasons.

There is no family or young person who does not have a mental health difficulty at some point. The most important thing is that the supports are there at the earliest opportunity. As somebody who has visited centres run by Jigsaw and has worked with Jigsaw on other issues, I found it incredible when I first met them that they were not operating in Waterford. I welcome that we are now moving in that direction. I also welcome that there is engagement with the local council on a premises. Hopefully, if the Minister of State secures the funding in the Estimates, this is something we can get up and running quickly in Waterford. It will be a fantastic addition for young people.

Conor McGuinness (Waterford, Sinn Fein)
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I agree that young people in particular are under huge stresses in this day and age. There is of course a need to constantly improve our acute mental health services, particularly for young people - children and adolescents. As I said, there is a need for early intervention and that wellness piece. There are great organisations working on the ground across Waterford and I met Pride of the Déise recently with Deputy Cullinane and understand the needs of the LGBTQI community. That is important. There is also Waterford and South Tipperary Community Service and Foróige, which the Minister of State mentioned. They are all making the case for additional youth mental health services, both in the community and on the acute side. There is a fantastic organisation called Laochas on the ground in Waterford promoting emotional and mental well-being among young children. Those need to be supported, but this is about equality as well. Waterford and the south east is the only region in the State without access to Jigsaw services. We all know, particularly after Covid, the need for face to face, physical services to be available. I ask the Minister of State to make the commitment that we will drive this on.

Mary Butler (Waterford, Fianna Fail)
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I certainly will drive it on, and it is an area that has been identified as needing youth mental health supports. However, all areas of the county need youth mental health supports. Some 2% of young people will need the support of CAMHS but 98% of young people - about a third of them - will need counselling and low-level supports so they can deal with anxiety, depression and the challenges they have with body image and social media challenges. All of that is huge. There are a lot of parents in the Dáil who will understand how difficult it can be, having young teenagers and young adults as children. Approximately €110 million of the mental health budget this year is being provided to various community-based mental health organisations and NGOs, including Jigsaw. Jigsaw already receives more than €14 million from the HSE under a service level agreement to provide youth mental health services. I have reached out to other organisations as well, because I have to provide supports in a good few communities and I have to try to get value for money. It does not matter to me who delivers the service once we have a good service, fit for purpose, and where the clinical governance is in place. I have identified four areas, which are Waterford and the south east, the Clare area, the Kildare area and the Cavan-Monaghan area, which is really important.

It is important that we acknowledge some of the supports that have come into the areas. As Minister of State, I introduced the model of care for our crisis resolution services. We now have a crisis resolution team operating in Waterford. It is currently working 9 to 5. I hope we will soon be moving to 3 to 11, Thursday to Monday, which is the model of care for crisis resolution teams. The most important thing with a crisis resolution team is that it is operational when other services are not there. We will also have a solace café opening very shortly in the city. That will be operated by Aware. It was previously known as a crisis cafe, but we changed the name. We know the café in Galway has reduced by 18% the number of people presenting to accident and emergency with mental health difficulties. I am fully committed to delivering this service for Waterford and I am happy to work with the Deputies.