Maura Hopkins (Fine Gael)
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I thank the Minister of State at the Department of Health, Deputy Catherine Byrne, for coming to the Seanad this morning. The important issue I wish to raise is the inpatient mental health unit in Roscommon town. As the Minister of State will be aware, a recent inspection by the Mental Health Commission has found that the unit is non-compliant with 14 regulations, one rule and four codes of practice. She will also be aware that an external report on mental health services was published last September. It is difficult for me, as a public representative, for people in our community and for people who need to use our mental health services and their families to have confidence in the acute inpatient mental health unit as well as the other services in the county when there is non-compliance in a number of key areas.

These inspections take place every year. I should emphasise that our results have been getting worse, not better, through 2015, 2016 and 2017. We are not making improvements. In 2015, there were 18 non-compliant areas, in 2016 there were 13 and in 2017 there were 19. That is very serious. I will highlight the difficulties that were found in the report. They are basic issues - I worked as an occupational therapist in mental health services - such as poor hand hygiene, no soap in dispensers, dairy products not stored at an appropriate temperature, inadequate staffing, no up-to-date training and broken handles on windows and lockers. One section of the report indicates huge issues with recreational space. It was described as a cage-like area. I acknowledge that work commenced last November on developing a garden at the inpatient mental health unit, which is something of an improvement.

However, I am not happy. We had a meeting last night with the Minister of State at the Department of Health, Deputy Jim Daly, about another unit, the Rosalie unit in Castlerea. There was no HSE management at that meeting. Who exactly is running our mental health services at present? I am not satisfied with the level of care being given to people who are going through very difficult times.I want to know exactly what measures are being put in place to ensure we do not see results like this again. I ask the Minister of State for a response that deals with the practical solutions that will be put in place immediately.

Catherine Byrne (Dublin South Central, Fine Gael)
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I thank Senator Hopkins. I will read the response I have been given. I may not be able to address some of the details. On behalf of the Minister of State, Deputy Jim Daly, who could not be here, I thank the Senator for raising this Commencement matter.

Mental health remains a priority of the programme for Government. Since 2012, around €200 million, or 28%, has been added to the HSE mental health budget which now totals over €910 million. This is a significant investment by any standard and the Programme for a Partnership Government gives a clear commitment to increase our mental health budget annually as resources allow to expand and modernise all aspects of our services, including those in Roscommon. One of the strategic priorities for mental health in the HSE national service plan 2018 is to deliver timely, clinically effective and standardised safe mental health services in adherence to statutory requirements. Specific provision is made to improve compliance through monitoring services in collaboration with the Mental Health Commission. The HSE’s national service plan 2018 also highlights the implementation of the HSE best practice guidance for mental health services, including developing and delivery of training and reporting for quality surveillance.

The Mental Health Commission is charged with visiting and inspecting every approved mental health centre at least once a year. On 15 March 2017, the commission published its report on the department of psychiatry in Roscommon University Hospital. This followed an inspection of the approved centre which took place from 5 September to 8 September 2017. While the facility received satisfactory rankings for elements of its performance, there were concerns raised by the commission on the detailed aspects of service delivery. The inspection team found, for example, that the unit failed in some respects on appropriate recreational activities, visitor areas, therapeutic services and programmes, privacy and premises, risk management procedures and admission and transfer and discharge records. Details of the full report are available on the Mental Health Commission website.

The HSE community health care organisation 2 has welcomed the commission’s report on the Roscommon acute psychiatric unit. A corrective and preventative action plan was drafted by the HSE following the receipt of the inspection report to ensure all issues identified in the report are addressed. The Minister of State, Deputy Jim Daly, is satisfied that the HSE is committed to improving this particular service overall and is in the process of addressing the specific issues highlighted. One of the main concerns related to a lack of proper garden facilities for the residents and the HSE has already commenced construction of a new garden at the hospital. The Senator may rest assured that the Department of Health and the HSE will continue to closely monitor the issues raised in the Mental Health Commission report to ensure the necessary corrective actions are progressed as quickly as possible. The Senator will also be aware that the report of the Roscommon mental health services was published last September. Good progress is being made by the HSE in implementing the 27 recommendations of this report to help modernise mental health services overall in Roscommon. This will by its nature help raise standards and practice for mental health overall in Roscommon, including inpatient and community-based services.

I will respond to any supplementary questions the Senator raises.

Maura Hopkins (Fine Gael)
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I thank the Minister of State for her response. She will understand how frustrated I am. I do not rest assured. We had a meeting last night with the Minister of State, Deputy Daly. There was no HSE management at the meeting on the Rosalie unit in Castlerea. I have absolutely no faith in HSE management of mental health services in County Roscommon.

The Minister of State mentioned action plans. We know the 27 recommendations of the report. I was at a meeting last Friday with the chief health officer, Tony Canavan, about the report. We were told an action plan has been developed. I would like to see a little bit of action from that action plan. I acknowledge there has been work on the garden. What about basic hand hygiene? What about broken handles on lockers and windows? What about food safety? What about mandatory training? What about staffing? They are all very serious issues. The response I got last Friday on mental health services in County Roscommon overall is not at all positive. We have absolutely no clear pathway to improve services in the county. The only words that were used at that meeting last Friday were about closures of day centres and hostels and the serious concerns that have been raised here. A strong focus from the Minister and Ministers of State in the Department of Health would ensure we improve things because we need to. Our people in Roscommon deserve better than this.

Catherine Byrne (Dublin South Central, Fine Gael)
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I can see clearly the Senator is very upset and frustrated by what has happened. The simple issues the Senator raised around hand hygiene, food hygiene and locks on windows are very common-sense things. Those of us who have an association with health services believe there should be management and leadership at grassroots level. Some of the small issues the Senator raised have not been corrected. That is down to the leadership and management at HSE level and at the level of the management of the service. We owe the best of care to people who go into a service like this. If the management in place is not sufficient to deal with the mundane, every-day clinical and hygiene issues in a centre like this we are in really deep trouble. I agree with the Senator on that.

I do not have details of a further clear pathway to give to the Senator but I will outline her frustration, which she has spoken about clearly, to the Minister of State, Deputy Jim Daly. I will ask him to meet or respond to the Senator in detail on the pathways to address the issue. I am very sorry I do not have specific answers and I understand the Senator's frustration.

Paul Coghlan (Fine Gael)
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I am sure the Senator appreciates what the Minister of State will do for her.