Wednesday, 19 January 2011
Mental Health Services
Cuirim fáilte roimh an Aire Stáit, an Teachta Roche. In welcoming the opportunity to raise the importance of mental health in society, I call for a unified, collective approach to growing problems in the area of mental health. The recent budget imposed a further cut in funding for these services. The budget for mental health as a proportion of health expenditure has been reduced from 7.9% to 5.3%. The promise set out in the programme for Government to publish a timeframe for implementing faster access to mental health services has been put on the long finger.
The implementation of the strategy, A Vision for Change, under which 8.4% of the health budget is deemed necessary to deliver an adequate service, has stalled. The United Kingdom spends in excess of 12% of its health budget on mental health. It is important to promulgate mental health as a serious issue because all of us in the Chamber know someone who committed suicide or is suffering from depression and myriad mental health problems, some related to the economic downturn and others to job insecurity and family circumstances. In his role as spokesperson on mental health my Fine Gael colleague, Deputy Dan Neville, has made the connection between job loss and suicide. The level of unemployment has trebled and the annual suicide rate increased by 24% last year, a worrying statistic. All Members agree that we cannot put a price on a human life.
I welcome the commitment of the Minister of State, Deputy Moloney, and acknowledge his genuine approach. I also welcome the commitment to the National Office for Suicide Prevention, but we need greater investment in the health budget. This can be achieved by making savings elsewhere. Some 1,500 nurses have left the mental health service in the past three years and the moratorium means there is no replacement of staff resulting in an inadequate staffing level.
At Cork University Hospital Ward GF in the psychiatric unit has not been upgraded or received the same level of investment as other parts of the hospital. It is important that it receives the necessary level of funding. Psychiatric services in Cork require urgent investment. We have not seen significant community provision as promised in A Vision for Change. Despite the great work of the staff who provide a tremendous service, Ward GF should be closed and a modern facility developed. This would benefit those who require the service and treatment and help to enhance morale among staff. It would also create a great sense that this society attaches importance to mental health issues.
It is important that we protect the most vulnerable in society. In 2009 some 200 children were admitted to adult psychiatric hospitals. That is not good enough and must change. I met Cork Simon Community and Samaritans which do great work with those under pressure. There is unprecedented demand on their services.
On our approach to mental health, there is a need for integration and a link between the Departments of Social Protection and Education and Skills to allow people to access FÁS training and become involved in education to increase their self-esteem and self-awareness. Rather than delaying implementation of A Vision for Change, we must give hope to the forgotten in the health service. In this regard, there is a need for firm commitments regarding mental health issues.
I thank the Senator for raising this issue. It is important to bear in mind that A Vision for Change is a work in progress over a period of seven to ten years. Given the current financial constraints, the maximum reduction in funding for the entire sector has been capped at 1.8%, relatively lower than in other areas. It is a dangerous delusion for anyone in this or the other House to suggest any part of the public service is outside budgetary considerations. There has been a significant increase in the incidence of suicide. Members on this side of the House are conscious of the importance of the issue.
Considerable strides have been made under A Vision for Change. The mental health service is leading the way in terms of service user involvement, an area in which people were being pushed away. The National Service Users Executive advises on issues relating to planning, delivery, evaluation and monitoring of mental health services. It has shown significant improvements. The NSUE report is due out soon and, while I cannot anticipate its findings, I understand the Minister of State, Deputy Moloney, is extremely pleased that it shows progress.
The Senator referred to the child and adolescent service, an area which requires a special focus. We now have 55 multidisciplinary child and adolescent mental health teams in place and a further five teams are in development. In terms of inpatient bed capacity, the number of beds has increased from 12 in 2007 - a low base - to 52 at present. New purpose built 20-bed units in Cork and Galway are opening this month. Work on the second phase of the child and adolescent unit at St. Vincent's Hospital, Fairview is due to commence this year. We were all moved when the problem in this area became apparent a number of years ago and in difficult circumstances efforts are being made to rectify it. It is proposed to replace the existing six-bed facility at Warrenstown, Blanchardstown, increasing capacity to 12 beds.
Central to implementation of a Vision for Change is the closure of old units, a matter which can be controversial. A number of old units will be replaced by more modern services. One example is St. Brendan's Hospital, Grangegorman, where acute admissions have ceased following the opening of the Pine Ward in Connolly Hospital. I remember visiting the hospital as a member of a health board and it smacked of Victorian times, notwithstanding the love and care shown by the staff.
Another subject of public debate is St. Senan's Hospital, Enniscorthy which is due to be replaced by a more modern facility to deliver better services in Wexford and Waterford, including day hospitals, a crisis house, high support residences and a community nursing unit. The decision of the Mental Health Commission to attach conditions to the registration of St. Senan's Hospital, requiring that new acute admissions must cease by February, has necessitated the acceleration of the planned acute service reconfiguration in the south east.
Plans for the transfer of acute inpatient admissions from St. Ita's Hospital, Portrane to a new purpose built unit on the Beaumont Hospital campus are proceeding. I am familiar with the hospital in Portrane and anyone who visited the institution was appalled. It was an extraordinary building built in Victorian times.
There are plans to reconfigure mental health services in Tipperary South. A residential unit is under construction in Clonmel that will allow for the closure of St. Luke's Hospital. It is also proposed to transfer the acute admissions facility at St. Michael's Unit, Clonmel to St. Luke's Hospital, Kilkenny.
See Change - the national stigma reduction campaign - will continue this year. The aim of the campaign is to positively change social attitudes and behaviour in order to encourage people in distress to seek help. This will feed into the valuable work of those who are trying to prevent suicide.
A Vision for Change is a work in progress and improvements will continue this year. There is a reduction of 1.8% in funding for this sector which is relatively low compared to the figures in other sectors. An additional €1 million has been provided for the National Office for Suicide Prevention this year. The achievements, therefore, in the mental health service are real. The issue concerns all political parties; it is not the domain of one party. Ireland was lagging behind in dealing with mental health issues, but we are catching up. Improvements have been made and there is room for more.
I should have said that the Minister of State, Deputy Moloney, asked me to mention in particular that he regretted he could not be here because he has been detained in the other House. Unfortunately, had we known about the change of time, he might have been able to be here. He is deeply concerned about this matter. I will convey to him the Senator's concern about services in Cork.