Eugene Murphy (Fianna Fail)
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Cuirim fáilte roimh an Aire Stáit, mo chomhghleacaí agus mo chara. I thank the Cathaoirleach for considering this matter and allowing us to debate it. I thank the Minister of State, Deputy Butler, for coming to the House to deal with this Commencement matter. The Minister of State's commitment to mental health and to older people is well recognised throughout the country. To be honest, communities continuously tell me about the great work being done by her. I want to acknowledge that here this morning.

It would be fair to say that it was during my time as a Deputy, that the Minister of State would have heard more about the old Rosalie Unit, as we discussed it over and over again. The centre was a home for several people who suffered from dementia. There was controversy when it was closed. That is water under the bridge at this stage, but a new centre was promised, which was announced in June 2020 by the then Minister of State with responsibility for mental health, Jim Daly. I believe the head of the HSE was there and, if I am not mistaken, then Taoiseach, Deputy Varadkar, was also online as was the Minister for Health.

This new centre was to be a day care centre for CAMHS and for psychiatry in later life, which is vital and important. There have been some developments there, and I welcome the commitment of the Minister of State, Deputy Butler, to the centre. I am informed that CAMHS' work is up and running on certain days in the week, which is very welcome. I am aware it is the Minister of State's desire to see everything that was promised is done. I am aware the Minister of State is committed, and that when she has something she wants to achieve that she will achieve it.

I am looking for an update as to where we stand with the new e-health centre in Castlerea, County Roscommon. There seem to be issues around psychiatry of later life services. Is it a staffing issue? I am aware that the Minister of State has provided the money. I do not know if there are issues around getting staff. It is important and crucial that once and for all we ensure this centre gets up and running as quickly as possible.

The Minister of State will also have heard me speak previously about the unspent money from 2012 to 2015, which was €18 million for mental health services for our county. That money was not returned. The money should have been put into mental health services at the time. It is still a big bone of contention with people and it is highly regrettable that this has happened. When the system needed that support it did not get it. This is an issue for the people who deal with mental health and with the public in our own county.

I will not delay any longer and I look forward to the Minister of State's reply. I hope that we can get some clarification this morning. I am sure the Minister of State will appreciate the absolute importance of the centre. It is great that it was promised. It is great that part of it is up and running, but we need to get the whole matter sorted now. I look forward to the Minister of State's reply.

Mary Butler (Waterford, Fianna Fail)
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It is good to see Senator O'Sullivan in the Chair.

Ned O'Sullivan (Fianna Fail)
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It is lovely to see the Minister of State, Deputy Butler, in the House. It would be remiss of me not to welcome you.

Mary Butler (Waterford, Fianna Fail)
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I thank Senator Murphy for raising this issue in Seanad Éireann. I can safely say that this is not the first time I have heard about this from the Senator. As Senator Murphy has said, we have spent a lot of time discussing the previous Rosalie Unit.

The project was announced by then Minister of State, Jim Daly, in June 2020, comprising a new CAMHS Connect day hospital and a psychiatry of later life day hospital. In 2020, €800,000 was provided for establishment works and staffing recruitment by the HSE. In 2021, 14 posts were approved with an allocation of €1.4 million.Staffing for the CAMHS Connect day hospital includes a consultant psychiatrist, a non-consultant hospital doctor, an advanced nurse practitioner, a senior social worker, a clinical nurse specialist, a senior psychologist and an occupational therapist. We are trying to put in place multidisciplinary teams around the country that will be able to support people with mental illnesses across all disciplines. The consultant, the non-consultant hospital doctor, the advanced nurse practitioner and the senior social worker for this team have been recruited. The remaining three posts are at an advanced stage of the recruitment process.

The following services are now available from the CAMHS Connect team: CAMHS multidisciplinary clinics, including a monthly mental health intellectual disability clinic; diagnostic assessments; cognitive behavioural therapy, CBT, and family therapy, which is important in supporting the families of loved ones with mental illness; outreach support; and CAMHS group work, which is being run to deliver therapy to young people. There is an existing psychiatry of later life service at Castlerea. Staffing for the new psychiatry of later life day hospital includes a consultant psychiatrist, a non-consultant hospital doctor, an advanced nurse practitioner, a social worker, a clinical nurse specialist, a senior psychologist and a senior occupational therapist. The non-consultant hospital doctor has recently taken up the duties of the position, and the remaining posts are going through the recruitment process and will be filled as soon as possible. Funding is allocated to the local mental health service as staff are appointed.

One of the real challenges being experienced is in recruiting staff. It can take up to 50 weeks to recruit and successfully put a person in place in a role, especially if the post must be backfilled. We are seeing this challenge with recruitment throughout the country and I have had many discussions about this issue. I met the CAMHS team in north county Dublin yesterday. When we are recruiting for staff, whether in the public, private or voluntary areas, and regardless of whether the recruitment is undertaken by NGOs or the HSE, we are all dipping into the same pool of personnel. It is difficult, but suffice it to say the will is there, the funding is there and recruitment for posts is under way.

The new psychiatry of later life day hospital on site will meet evolving mental health needs across a wide catchment area. A major component of the new services is outreach to emergency and inpatient units through telepsychiatry. This approach will continue to be developed by mental health professionals. The new psychiatry of later life day hospital reflects a new and improved approach to meeting the mental health needs of older people in the region, compared with the old Rosalie unit which was based on the same site in Castlerea. The day hospital will provide a real alternative to inpatient mental health care in Roscommon and will facilitate older people living in their own homes or in nursing homes. Specific programmes will be delivered for older people with severe mental health difficulties and individuals with dementia, including a new memory clinic. The service will provide another option in addition to acute hospital care, delay admission to continuing care and provide carer respite capacity. Services also include cognitive behavioural therapy and other therapies, anxiety management, recovery programmes, as well as art, music and healthy living skills.

Eugene Murphy (Fianna Fail)
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I welcome the statement from the Minister of State. Commitments were given regarding CAMHS and they have been fully looked after with these developments. I welcome that the Minister of State addressed the subject of the psychiatry of later life, but it is now clear that some issues remain concerning staffing. The Minister of State explained the situation very well in respect of how long it is taking to get staff into certain areas. The good thing I take from what the Minister of State said is that good progress is being made in this area.

It is also interesting to note what was said about telepsychiatry. Things change and this is something new and it will be part of how we deal with issues such as this in future. It is clear from what was said that this service will be up and running fully and that new ideas and approaches are emerging. I would love if the Minister of State would come to visit County Roscommon and this centre and have a discussion on these issues, including going through what is happening there. It would be well worthwhile. The invitation has been issued now, and I hope the Minister of State does not think I am being cheeky in pushing it on her like this. We would love to have her down there with us soon to discuss this matter further. I thank her for being here this morning and for her clear answers.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator for his positive approach. The Castlerea mental health hub represents a new approach to developing options in mental health services delivery, including the psychiatry of later life. It is my intention, and that of the HSE, that the Castlerea hub will help to inform this objective nationally. I will take up the Senator's offer to visit his county to see the centre. As I said, this is a new approach to developing options in mental health services and it is so important. One of the things I was most pleased to secure funding for in the budget for next year is in the context of the integrated care programme for older persons. Everyone will be aware of what the programme does, but it does not deal with the psychiatry of later life. I secured funding for three pilot teams so that we will not be duplicating services in this area. If an older person presents with frailty, a broken hip or related issues, any issues concerning the psychiatry of later life can be addressed then as well. I am pleased about that.

Mention was made of the €18 million. When I came into my post last year, there was a deficit of €53 million in the area of mental health services in the Department of Health. I have managed to clear that and we are going into next year with no deficit. Working with the Department and the HSE, we went back as far as 2012 and we were able to see where some savings were made. One relevant aspect from my previous life is that I was good at figures. What we have been able to do is to secure the budget for the future. None of the €1.149 billion funding allocation for mental health services is owed or will have to be spent on something that happened previously. I am very pleased about that aspect because it is so important in light of Covid-19 and all the other challenges that people face that we have a good and robust mental health system. I look forward to visiting Roscommon and my office will talk to the Senator about it.