Thursday, 20 November 2014
Mental Health Services Provision
That is fair enough.
I wish to raise the matter of the inpatient and acute psychiatric service in Navan. I understand there are plans to close the inpatient service in the new year. When a new unit opened in Drogheda, we all very much welcomed it. The more we can do for people with psychiatric conditions, the better. There are too many people dying as a result of diseases of the mind. We were told the service in Navan would not be affected but it now appears that the inpatient service is to be shut. This will be a huge loss. Suicide awareness and prevention groups are telling us that people may die as a result of the decision. I would like to hear the Government justify the decision to close the inpatient acute service in Navan, if it has been made.
I thank the Senator for raising this issue as it is important to keep to the fore the progress on implementing the widely accepted policy in A Vision for Change, in line with the need to modernise mental health services across the country. It is clear from the many occasions that mental health has been raised in both Houses in recent times that there is widespread agreement in the Oireachtas that we should put in place services designed for the needs of service users today, rather than those considered adequate in the past. We have, therefore, continued to prioritise programme for Government commitments to enhance mental health services towards community-based care, while developing a more integrated, person-centred and recovery-based service overall.
The recent budget announcement of a further €35 million for next year brings to €125 million the funding ring-fenced by the Government since 2012 to improve mental health and suicide prevention services in line with best practice nationally and internationally. Despite overall financial pressures, and increasing demands across our care system, the HSE mental health budget increased from around €711 million in 2012 to €766 million this year, with the 2015 position currently being finalised in the context of agreeing a new annual service plan for the HSE.
In light of the reforms of mental health services now taking place generally, and to provide the most efficient and effective combination of services in each region, the HSE is amalgamating acute psychiatric inpatient beds between Our Lady's Hospital, Navan, and St. Brigid's Hospital, Ardee, to the campus of Our Lady of Lourdes Hospital in Drogheda.
A Vision for Change supports provision of high-quality acute inpatient units based at major general hospitals as an important element of community-based mental health provision. The new building in Drogheda is at present under construction, and the opening is scheduled for the second quarter of 2015. The development will be a major improvement to the quality of the environment within which acute mental health services are currently delivered for the Louth–Meath area.
Discussions are ongoing on a proposal to use the existing inpatient unit in Navan as a day hospital for the wider hinterland. This would cater for clients who are acutely ill but who do not need 24-hour care. Day hospitals offer an alternative to inpatient admission for at least a proportion of service users. There is strong evidence that acute day hospital facilities are suitable for a quarter to one third of service users, who would otherwise be admitted to hospital.
The HSE is also making progress in Louth and Meath on the provision of fully staffed community mental health teams, involving reconfiguration as guided by A Vision for Change. Over the past two years, many new multi-disciplinary staff have been allocated to such teams, including social workers and occupational therapists. Community mental health teams are central to a modern mental health service, thus supporting clients to remain in the community. The development of the day hospital model across Louth and Meath would further realise this objective.
Community supports are also provided by the HSE via the home-based treatment team, and assertive outreach teams, in Louth and Meath. These are geared towards early intervention and avoiding admission to inpatient facilities.
As a day hospital, supported by appropriate community services, the unit in Navan will continue to be an integral part of mental health services in County Meath. The day hospital model is also progressing in Dundalk, Drogheda and Ashbourne.
I acknowledge that the Minister of State, Deputy Kathleen Lynch, is away and cannot be here. We all supported A Vision for Change. It was our policy and I believe everybody agrees with it and always did. We want to see it implemented as best we can.
If we read the Minister of State's script very carefully, we will note there is no actual commitment to maintaining Our Lady's Hospital, Navan, as a day hospital.
What the statement says is that discussions are ongoing on a proposal to use the existing inpatient unit in Navan as a day hospital for the wider hinterland. That conditional mood is used further in some of the other paragraphs. We are not certain if it will even remain as a day hospital but certainly any removal of the inpatient beds there will be a regressive step for County Meath. I would urge the Government to let people know what is happening. Too much is being leaked and given out mar dhea with phrases like "this might happen" or "that would happen". People want to know the plans for services. We know what A Vision for Change is but what are the practical implications on the ground? If someone needs help, where do they go? It seems that this is up in the air. We certainly welcome the opening of the unit in Drogheda but we do not know what is happening in Navan. The Minister of State, Deputy Lynch, has not been able to give any real commitment on that. I look forward to getting further details from her when she returns.
I warmly welcome Senator Byrne's endorsement of A Vision for Change. It is very important for mental health areas that we get a commitment to a community-based care centre. I know Senator Byrne is very committed to that himself. I thank him for bringing this to the attention of the Minister of State, Deputy Lynch, and I will ask her to communicate with him on the specific items he has raised in his response.