Mary Butler (Waterford, Fianna Fail) | Oireachtas source

A lot of issues were raised today and many comprehensive and supportive comments have been made. I have to take offence at a few and I will go through them one at a time. It is great we are all here today discussing mental health. That is the most important thing. Every time we speak about mental health, we lessen the stigma.

I cannot respond to any individual cases. I will not respond to individual organisations. What I will say is that when organisations are seeking funding from the mental health budget, certain things have to be in place. Organisations have to have a board. It is also very important that they have accounts they can bring forward when seeking funding. They need to have governance, including clinical governance. I will not stand over any organisation that cannot provide me with the proper clinical governance in terms of supporting people. Clinical governance is essential.

I hear constantly that the Government will not fund such-and-such an organisation. Last year, the mental health budget provided €110 million to organisations. I am struck by the briefing notes provided to some Senators. Some Senators have sought funding, which is fair enough. I am a Deputy and I will always do that. However, some Senators criticised the fact that €97 million was spent on private organisations. I would advise those Senator that the correct figure is €110 million, which was allocated to organisations like Jigsaw, MyMind, turn2me, the Samaritans, Pieta House and Mental Health Ireland. Any Senators who have a problem with funding being allocated to private organisations must realise they are, in fact, NGOs. They have service level agreements. I ask Senators to let me know which of the organisations they would like me to defund. I have no problem looking at that.

Some Senators mentioned dual diagnosis and there are some inaccuracies about that. Sharing the Vision, our mental health policy, was announced in 2020 and I am surprised some people did not know it is very clear that dual diagnosis is included. It was not included in the previous policy, A Vision for Change, which was problematic. People were siloed. Those with addiction issues could not go for mental health support and vice versa.

In 2023, I launched a new model of care in respect of dual diagnoses. The model of care acknowledged that treatment options need to address people's mental health problems and deal with addiction issues at the same time. It also recommended the development of 12 adult and four youth and adolescent teams. We are now building this up because we have to build services incrementally from a funding perspective and get the right staff. At the moment, we have two adult teams and two adolescent teams in operation. In budget 2025, I secured funding for a further two teams which will be operational this year. We started in 2023, and by the end of this year, six teams will be up and running. It takes time. As I say, it takes a village. I will continue to do that work as long as I am in this role. To be very clear, we are not ignoring the area. Budget 2025 has additional funding of a recurring €1.3 million to start the two new teams. It takes a while to build a team. They are led by a consultant psychiatrist. It is very important that these multidisciplinary teams are built. We are making progress on this but I acknowledge the situation with dual diagnosis and the big problems we have with addiction.

I acknowledge Stephen Sheil, the communications and engagement manager from Mental Health Reform, who has sat through the entire debate. I thank him and the entire team for their continued support.

I want to touch on the recent report from the chief inspector of the Mental Health Commission into mental health care in emergency departments. The report made important recommendations on the timeliness of assessments following presentation to emergency departments. I do not believe emergency departments are the appropriate environment for people in mental health crisis. At the same time, the reality is that this is what we are dealing with at present. There have been many calls for separate rooms or a separate pathway in but these would not lessen the stigma of somebody who has a mental health issue. We all have mental health and many of us have positive mental health. Many people are challenged at different times with regard to their emotional well-being and their peace of mind. At the same time, when people are in distress we need to keep rolling out the crisis resolution teams, which we are doing at present, and the crisis cafes, which are very supportive. For example, the new cafe I opened in Cork last year, on Sullivan's Quay down beside the River Lee, has reduced by 18% the presentations of people in crisis. We continue to do this across the board.

We also continue to roll out suicide crisis assessment nurses, SCANs. There was talk about high levels of suicide in the Cavan and Monaghan area. I was delighted to see figures this morning from Cavan and Monaghan with regard to CAMHS, with seven children on a waiting list. This is not the case in the rest of the country. There are areas that can perform very well on some issues. I provided two SCANs in Cavan and Monaghan, which had been requested by Deputy Niamh Smyth. These two SCANs have had a big impact.

Another issue on which I am spending a lot of time is CAMHS because I am not happy with where we are on waiting lists. I am far from happy. This year the budget for CAMHS is €167 million. As I have said, €110 million is provided to community-based mental health organisations. They are not private organisations but community-based mental health organisations. I have to distance myself from a comment made by Senator Stephenson, who said that CAMHS is not fit for purpose. As I stand here, young people throughout Ireland are receiving appointments from multidisciplinary CAMHS teams. Everybody who goes to work in CAMHS goes with the best of intentions to do the best they can. CAMHS has taken a hammering in recent years. I will not stand up and allow this to happen. There are 810 people working in CAMHS at present. There are 80 consultant psychiatrists. Every single one of them goes to work every day to do the very best for the young people they see.

I have said quite clearly I am not happy with the waiting lists and I have visited six CAMHS teams in the past four weeks. I will visit two more on Monday. We have to delve into the reasons for this. Some teams may not have as many staff as others, they might have a bigger catchment area or the premises might not be appropriate. There are many reasons. The funding is being provided. Unfortunately, we see more and more children presenting with issues. It is correct to state there is pent-up demand since Covid, and young people are very distressed. They are distressed with regard to their mental health and with regard to trauma issues or issues they may be dealing with at home. I thank everybody who works in CAMHS every day of the week because it is not an easy job. Senator Stephenson made the statement that CAMHS is not fit for purpose when 23,000 appointments were issued to young people last year. It does a phenomenal job working with very vulnerable and sick children. I want to give a shout out to all of those working in CAMHS because it is very important.