Brian Stanley (Laois, Independent)
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I thank the Minister of State and am happy she is here as a resident of Laois. I know she is just inside the border, but she is still in Laois. I raised this back in April 2022. On Holy Thursday of that year, I became aware from a source that there were plans to close Erkina House in Rathdowney. Erkina House at that time had 12 residents and €120,000 had just been spent re-roofing part of the building. There was an almighty campaign to keep it open. The decision to close it was not notified to the Minister at the time, and he confirmed that in writing and here on the floor of the Dáil as well. At the time I predicted that the HSE might sit it out, have a war of attrition and let the numbers dwindle down as people passed on, returned to a ward or a nursing home, or were convinced to go somewhere else. Unfortunately, that seems to be what has happened. A consultant was brought in to meet with residents, families, staff and public representatives and we all participated in this. Views were taken, and the view that came back very strongly supported retention of a facility on the site of Erkina House.

The points in favour were the excellent staff in the facility; that it is on a large site in the centre of Rathdowney town with large gardens behind it - it is the old convent house; that it has easy access to shops and a post office directly across the road; and that there is a cafe, local facilities and the health centre, with the library adjacent to it. All of these were used by some of the residents. One person in it was writing poetry. He was moved the other day. Another person who died very recently had produced wonderful artwork, which I have viewed over the years. There is a regular bus service from Rathdowney. An excuse used by the HSE and the Department of Health at the time was that there was no transport in and out. There is a very good bus service in and out of Rathdowney and that will improve further under the rural link scheme, which is a great scheme. I welcome that.

One of the other great points in favour of the facility was the support and acceptance of the residents by the local community. The residents knew local people, and local people knew them and would chat to them. The residents were familiar with the local people and the surroundings. The HSE and the Department produced an order of merit report on the building, looking at options. Refurbishing and extending it had a projected cost of €5.2 million. Obviously, there was a cost in producing that extensive report. A firm of architects was brought in to do it.

The current situation is that the facility is down to just two residents. This is what I predicted would happen. Some of them have been moved. The HSE and the Department have sat it out. Some residents have moved to a nursing home and some of them have gone to their eternal and just reward. There were a number of meetings with the HSE and various options were discussed. I followed this the whole way along. We were told the preferred option for the HSE was that there would be four of these centres in Laois and Offaly, two in Laois and two in Offaly. There is already Silver Lodge in Tullamore and the one in Borris-in-Ossory. Those are the two in Offaly. In Laois, there is the Maryborough Centre, which was being refurbished at the time. It has been reopened now and is fantastic. There are up to 15 residents in that. That is good, but I pointed out at the time that Rathdowney is ideal because it is at the other end of the county. It provided care for the south of the county.

It already owns the site but what we have had since is pussyfooting or deliberately sitting it out. I do not know which it is but no decision has been made. This is not acceptable. How long does it take for decisions to be made in this country? Ministers really need to catch officials and move things on. I ask the Minister of State what is the truth and what is happening. We need an upfront answer.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank the Deputy from my neighbouring county for raising this important matter. It is a key priority for the Minister of State, Deputy Butler, who, unfortunately, she cannot take this Topical Issue, and for the Government that people experiencing mental health difficulties receive the appropriate level of care they require in the most suitable location in the community that best meets their needs. Achieving this involves reform of mental health services and developing fit-for-purpose community services that meet people's needs into the future. This is supported by substantial investment in mental health services each year.

Erkina House is operated by the HSE as a fully staffed community mental health residence. The HSE has advised the Department that there are three remaining residents supported at this residence. Erkina House has provided much-needed mental health support to many people over two decades. However, it is not the type of mental health service we would build today and there are documented issues with the configuration of the building as a mental health service. The HSE has been actively engaging in working towards a solution that meets the long-term care needs of the service users remaining at the facility. The HSE have advised the Department of Health that Erkina House would be significantly non-compliant with forthcoming Mental Health Commission community residence standards and a significant level of investment would be required to develop Erkina House to achieve the additional regulatory standards required.

An independent review was commissioned by the chief officer in the HSE Midlands Louth Meath community healthcare organisation in 2022. The review was completed on the basis of a potential move of services to another location in County Offaly. This is no longer an option being considered by the HSE. The review strongly recommended that the views of residents on their future service provision be the focus of decision-making. This person-centred management model has been undertaken by the HSE which indicated that the remaining residents wish to move to other long-term care facilities in their community. The HSE has advised the Department that this property is not suitable for upgrade and adaptation and accordingly no new admissions will be undertaken. The HSE has provided assurance to the Department as to the service provision for the existing residents to properly meet their needs. I will not go over these details as the number of people involved is so small that they could be identifiable. The HSE aims to re-provide this service and provision for community-based high support which will be managed in existing alternative mental health residences located within the integrated healthcare area.

Brian Stanley (Laois, Independent)
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I thank the Minister of State for her reply. As of yesterday, my information is it was down to two residents. We have known for three years that the building will not meet standards. The HSE, the Government and the Department know it. In the meantime, HSE management was clear it needed four centres and the ideal size of those centres was to cater for between ten and 15 people because that provides the best model in terms of efficiency, use of resources and best practice for residents. It outlined in great detail why. Where is the fourth centre going to be? We have three in Laois-Offaly. The Department of Health owns this site. There is a building there. I recognise this building needs an upgrade but if there are going to have four centres, surely one should be located in south of the county along with one up towards the north and the centre in the middle of the county, which is in Portlaoise. That is excellent; I welcome that centre. I visited it and it is wonderful what is happening in it. The Minister of State will know that people being let out of mental health facilities and sent home who really need to be in care. Families contact me about people who are being sent out of the psychiatric unit, brought in for a couple of days and sent out again. Those people need to be in residential care. That is well recognised by medical professionals but there is nowhere to send them. They are not fit to hold down a tenancy in a house or to live in group supported accommodation but in a setting like that, they function. The HSE recognised that at the time so what has happened? The most recent reply I got to a parliamentary question was that no decision has been made regarding the future of Erkina House. We need to get straight answers as to what is happening. I ask the Government to use this resource and opportunity, make decisions and put a facility in place in the south of the county. Utilise the goodwill and staff who are there also.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank the Deputy again for bringing this important issue up. I assure the House that I understand, as the Deputy said, how important it is for all persons with mental health difficulties to have the relevant mental health services in place from the HSE in the location that best suits their needs. The Deputy mentioned the four centres and that they should be based in different areas. I will check that out with the Minister of State, Deputy Butler. I will also check the site with the HSE. The Deputy said Erkina House is a HSE site. I will also speak to the Minister of State and Department. I assure him someone will come back to him with this information. I note this is a priority for Deputy Butler and I will go back to her with the Deputy's concerns.