Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

Before I give Senator Moran the official reply I wish to emphasise that we have got money for the past two years and that a further €20 million has been allocated this year for additional development funding for mental health. I discussed the matter with some people in advance of the allocation this year. The two areas where we knew we needed to work on this year with the additional money were the areas of old age psychiatry and intellectual disability. This is because if children or young adults have an intellectual disability it does not protect them from difficulties with mental health. Indeed, sometimes there is a crossover and we need a specialised area to deal with that.

I thank the Senator for raising this topic today. The Government has prioritised reform of mental health services in line with A Vision for Change and it is committed in particular to the delivery of more and better quality care in the community. This includes enhancing and streamlining, as appropriate, service interactions for under 18s between the mainstream mental health and disability care programmes.

Total HSE mental health funding in 2014 is in the region of €765 million but that does not include the development money. This reflects the additional funding of €90 million together with approximately 1,100 new posts provided over the past three years to modernise our services. Primarily, the modernisation has focused on the following: strengthening community mental health teams for adults and children; enhancing specialist community mental health services for older people with a mental illness, including services for those with an intellectual disability and mental illness; and upgrading forensic mental health services in line with A Vision for Change.

The Senator raised another important point. We have held discussions with CAMHS for the past two years in respect of children between the ages of 16 and 18 years. We cannot possibly say to people, whether they have a disability or otherwise, that somehow or other they do not exist because they happen to be in that age bracket. I have been assured that this age cohort is now going up to 17 years with a view to it going up to 18 years in subsequent years on the back of the additional resources we have provided.

The recent establishment of a new mental health management structure within the HSE has been designed to bring greater clarity to services, including multidisciplinary care at national and local levels.

We have given greater recognition to the fact that child and adolescent mental health services, in both policy and practical terms, will inevitably have a role in some cases, at least in cases of difficult diagnoses, and in terms of specialist episodic treatment of acute mental disorders. This is a specific implementation requirement of A Vision for Change.
In regard to the issue raised by the Senator, the HSE has indicated that until last year, there was no dedicated service available in County Louth in mental health for either adults or children with mental health issues and an intellectual disability. Notwithstanding the lack of services available locally, there were none the less some supports from child and adolescent mental health services, and as the Senator rightly pointed out, voluntary organisations and disability services have been doing their best. These in turn were supported by a consultant psychiatrist providing two sessions per week. That is clearly not enough.

In terms of new service development posts approved for 2013, two teams, each led by a consultant psychiatrist were approved for the north east for adults, and this service is currently being established. The recruitment process to fill these posts is progressing. In addition, the local HSE is exploring the question of appointing a CAMHS consultant with a special interest in intellectual disability for children. This proposal is at a very early stage and the Department of Health has asked to be kept informed of developments on this matter. The HSE national service plan for 2014, including associated operational plans for regional and local services, commits to a number of key deliverables for this year. As I have indicated on many occasions in the past, early, appropriate and effective intervention is key, coupled with a strong recovery-based approach for young people with mental health issues.

By raising this issue tonight, the Senator will again put the focus back on that service. We must ensure that when an adult with an intellectual disability has a difficulty with mental health, there is a service available to him or her. I will once again take this up with the director as appointed.