Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister of State to the House. This morning, the Oireachtas heath committee met representatives of the Mental Health Commission and of a group campaigning for mental health reform. Presentations were made to the committee and many interesting issues arose at that meeting. I raised a number of issues myself about which I am concerned but it is important to recognise the progress that has been made. The budget for mental health has increased from €711 million to €987 million over the past four to five years, which is a substantial increase. The number of CAMHS units has increased from 49 to 70 and the number of new posts created is over 1,700. Progress is being made in relation to mental health. A new national forensic mental health hospital is being built. It will have 130 adult beds, as well as a ten-bed unit for children and a 30-bed intensive care rehabilitation unit, giving a total of 170 beds. That project is progressing, is being built and will be delivered.

The Mental Health Commission provided figures at the meeting this morning relating to regulatory compliance, which is improving. Regulatory compliance went up from 74% in 2016 to 76% in 2017 and it reached 79% in 2018. One of the examples given to us related to the department of psychiatry in Roscommon hospital, which was only 52% compliant over 12 months ago but at the last inspection was found to be 83% compliant. Similarly, St. Brigid's Hospital in Ardee was way down the list but has now reached 93% compliance. Progress is being made in relation to mental health, albeit not enough and not fast enough. That said, it is important to note that it is not static and that the necessary changes are being made.

Senator Mullen referred to the number of beds in the system but we have now changed the whole focus of mental health services. The focus is on community and working in community teams. This is not just about in-care beds but also about working within the community; it is about working not only with the patients but also with their families, which is extremely important. Families are so important in terms of providing support and we must make sure that they are involved in the care of their loved ones who have difficulties in their lives. People need care and must have someone available to them when they have a down-time and need support.

I raised a number of issues at the health committee meeting this morning about which I have concerns. One is the issue of adolescent mental health, with which I have been dealing over the past 12 months. It is an enormous challenge at the moment, particularly with regard to geographical boundaries. In the Glanmire area of Cork city, for example, no adolescent mental health consultant was available. As a result, parents with whom I was dealing could not get access to consultant assessments for their children because they were living in a particular catchment area. It is unfair that people living on one side of a boundary cannot get access to a service while those who are fortunate enough to live on the other side of the boundary can access such services. That issue must be addressed. I have never heard previously of boundaries being created in respect of healthcare but that appears to be what has happened in the psychiatric services. This is something that needs to be examined further because there is a reluctance to roll over access to services for those who need immediate care.

Another issue is the fact that there is no intermediate support for people if they have not been assessed by a psychiatrist. They cannot get access to a CAMHS team because of the way the system is currently structured. That needs to be examined again in the context of making sure people can get access to services. The other issue that must be dealt with is one that requires forward planning. We have a large number of people living in this country now who were not born here. I dealt with a very difficult case recently where a GP told a landlord whose tenant had serious mental health problems to contact me and that I would sort it out for him. Eventually, after four weeks of back and forth, we got the GP to call to the person, who was then admitted to the psychiatric unit in Cork University Hospital. The sad part of this is that the person involved does not have family support. We are going to have a problem in the future with people who have come into this country but who do not have the support of immediate family or relatives and we need to start planning for that. The person to whom I referred has now been discharged from the psychiatric services but is facing issues with regard to accessing accommodation and the necessary supports. We must look at these two areas.

Finally, I wish to refer to the connection between drug abuse and the development of mental health problems. We are not doing enough to educate people that the use of illegal drugs can lead to mental health problems. We need to do a lot more to educate people in that regard, just as we did with tobacco and how smoking affects health. The use of illegal drugs causes mental health problems in the long term and we need to get that message out.

I thank the Minister of State for the work he is doing and commend his Department and the HSE on the work they are doing in this area. However, there are issues for which we must start planning now.