Keith Swanick (Fianna Fail) | Oireachtas source

Dr. John Hillery recently resigned as a consultant psychiatrist in the HSE after nearly 30 years working in mental health and intellectual disability services. He was not due retire from his post until 2022. He did so in protest over the treatment of staff and patients within the State’s mental health services.

Last week Dr. Kieran Moore, a specialist consultant paediatric psychiatrist, told the Oireachtas Joint Committee on the Future of Mental Health Care that he and two of his colleagues from the south-east region were resigning because they were concerned about working in unsafe conditions. Dr. Moore said that he was resigning because it is untenable and unsafe and that two of his colleagues were doing the same. He said patients were coming into a building that is in a state and where staff are burnt out. He said mental health services required continual funding and looking after the people who look after patients.The prevalence of those suffering from mental health problems was increasing, he said, describing the issue as "a national emergency".

Unless the psychiatrists are replaced, there will be no services for children in Wexford and Waterford and it is scandalous that children in this region face the prospect of having no public consultant psychiatric services from next month. I refer to an important point my party colleague Deputy James Browne raised in this regard and, perhaps, the Minister of State can provide some clarity. It is Deputy Browne’s understanding that all other CAMHS staff who have been working under the psychiatrists such as psychologists and occupational therapists can no longer effectively do their jobs because they have no one to oversee them. Will he confirm that this is the case? Where does this leave them? Will the other CAMHS staff be relocated? Will they be allowed to continue without a psychiatric consultant to oversee them?

According to the Irish Hospital Consultants' Association, of the 44 consultant psychiatrist posts advertised in 2015 and 2016, practically a quarter had no applicants and 30% had only one applicant. Sixteen consultant psychiatrist posts advertised for interview in 2016, including posts in child and adolescent psychiatry, learning disabilities, forensic psychiatry, general adult psychiatry, and psychiatry of old age, received no applicants whatsoever. These competitions with no applicants were for posts in Sligo-Leitrim, Cavan-Monaghan, Cork, Carlow-Kilkenny, Donegal, Longford-Westmeath, Laois-Offaly, and Waterford-Wexford and the Central Mental Hospital. This is not problem confined to the south east but the services there are in dire straits. I acknowledge what the Minister of State said about support from Galway-based consultants. However, the position in Galway is not much better and, therefore, this is only a stopgap measure.

According to recent figures provided to Fianna Fáil, 6,181 children were waiting for a primary care psychology appointment at the end of January 2018. Of the young people waiting, some 1,635 of them have been waiting more than a year to be seen. This means these children spent all of 2017 waiting for an appointment.

I have made several suggestions over the past year. I try to be practical and solution-driven. The proposal for a 24-hour helpline that is accessible to GPs for vulnerable children and teenagers who hit a crisis in mental health should be considered. In that case, a GP can pick up the phone and access CAMHS in an emergency. Such a service would not be abused and it would mean unnecessary referrals to emergency departments would be avoided. In a crisis, when young kids and teenagers are vulnerable, emergency departments are not the correct place for them to present themselves for assessment and I ask the Minister of State to take this on board. I have had people in my surgery in the middle of a mental health crisis when the help they require is immediate and urgent. They are vulnerable and it is shameful to then tell them they must wait more than a year for an appointment.

I hope the Minister of State will take this on board and I look forward to working with him on this issue.