Seanad debates
Thursday, 15 June 2023
Nithe i dtosach suíonna - Commencement Matters
Mental Health Services
9:30 am
Paul Gavan (Sinn Fein)
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I thank the Minister of State, Deputy Rabbitte, for coming in. She will know that the report of the task force on youth mental health was published in 2017. Subsequently there was a commitment by the Government to set up a pathfinder unit for youth mental health. One of the asks of the youth mental health pathfinder project was to effectively embed a new model of cross-government working using section 12 of the Public Service Management Act of 1997. This pathfinder project is crucial to opening up a more collective approach to youth mental health, facilitating the working together of several key Departments, namely the Department of Health, the Department of Children, Equality, Disability, Integration and Youth, the Department of Education and the Department of An Taoiseach. Organisations such as the Irish Society for the Prevention of Cruelty to Children, Mental Health Reform, BeLonG To Youth Services, and Spunout.ie, as well as Professor Mary Cannon of the Royal College of Surgeons in Ireland, Dr. Tony Bates, and other individuals and politicians have continuously highlighted how children and young people have been seriously impacted by delays in access and lack of resources in mental health services in Ireland. Six years later, there has been no action by the Minister of State's Department to deliver on this commitment.
Responses to several parliamentary questions from various Deputies including my good comrade, Deputy Mark Ward, have received almost identical responses each time. This response states that the proposal is to formalise a new model for collaborative working within government and place a pathfinder unit on a statutory footing through section 12 of the Public Service Management Act 1997. The response goes on to state that as this section has not been used before, various administrative, budgetary, governance and legal arrangements need to be developed and agreed with the Department of Public Expenditure, National Development Plan Delivery and Reform to ensure a robust and workable model for the unit. It goes on further to state that the demands on both Departments during the pandemic have presented challenges in progressing the proposals and that nonetheless, the Department of Health has engaged with the Department of Public Expenditure, National Development Plan Delivery and Reform to develop an implementation option that fully addresses these issues. That is a very long way of saying that this is complicated and the Department is too busy. Is that really what the Minister of State's Department and the Government are telling our children and young people at home who are waiting years for appointments for their mental health?
The mental health services are beyond a crisis. We have seen a damning report in January and the spotlight report released at the beginning of May. We know the situation is dire. We have reached record numbers waiting for first-time appointments with child and adolescent mental health services, CAMHS, with 4,434 waiting overall, of whom 682 are waiting over a year. This is a rise of 110% and 215% respectively since the Government first took office. There are more than 11,000 children waiting for an appointment with primary care psychology. Some 22% of children in community healthcare area CHO 3, which covers Limerick, are waiting longer than a year for their first appointment. Jigsaw in Limerick has waiting times of around 18 weeks, nearly five months for a young person in crisis to be able to get some support. CAMHS must be extended to help young people up to the age of 25, by which age 75% of chronic mental ill-health has been established. Provision should also be made for child counselling in primary care. I want to stress the importance of setting up the pathfinder unit as a matter of urgency at a time when youth mental health services in this country are wholly inadequate and in a state beyond crisis point. That the Government has not progressed the long-awaited pathfinder unit after six years is another piece of damning evidence that it does not treat mental health and the well-being of our children and young people with the urgency it deserves.
Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Senator for raising this important issue. I am taking it on behalf of my colleague, the Minister of State, Deputy Mary Butler. The Government remains committed to the development of all aspects of mental health services nationally, including those for children and young people. This is reflected by the record allocation of over €1.2 billion for mental health in 2023, which includes a wide spectrum of services for young people ranging from prevention and early intervention to clinical programmes or acute inpatient care. The Sharing the Vision policy has various recommendations relating to children and adolescents, including promoting a more holistic and whole-of-government approach.
In terms of child and adolescent service development and improvement, a significant recent announcement under the HSE service plan 2023 is the creation of a new post of youth mental health lead at assistant national director level, and a new clinical lead for youth mental health. These posts will allow the HSE to focus on the provision of more integrated services for young people, as envisaged under Sharing the Vision and Sláintecare.
With regard to the proposal to establish a cross-governmental youth mental health pathfinder unit, ministerial approval was received during the previous Government to convene an interdepartmental group with participation from the Department of Health, the Department of Education and the Department of Children, Equality, Disability, Integration and Youth. In addition, its establishment is contained within the current programme for Government. It has always been envisioned that such a collaborative approach would provide a beneficial way to address service improvement, and would help to ensure that barriers to accessing mental health services by young people are broken down, with the benefit of services being integrated, signposted and accessible. This integration of accessible, signposted services remains to the forefront of all youth mental health service improvements.
However, as the Senator will be aware, the demands on these Departments during the pandemic have presented challenges to progressing the pathfinder unit.The realignment of departmental functions in the education sector, specifically the establishment of the Department of Further and Higher Education, Research, Innovation and Science, has also necessitated some further consideration of the initial proposal and make-up of the pathfinder unit. This is not to say that work in this area has not continued or that important interdepartmental collaboration has not continued. As my colleague, the Minister of State at the Department of Health, Deputy Butler, will confirm, improving mental health services for young people is a key focus for her and her Department. Opportunities for service improvement and policy implementation are constantly being actively engaged in by both the HSE and officials in the Department of Health.
To this end, I can confirm to the Senator that the Department of Children, Equality, Disability and Integration and Youth is currently developing the next national policy framework for children and young people as a successor strategy to Better Outcomes, Brighter Futures. As part of this work, that Department is liaising with the Department of Health to launch a youth mental health spotlight programme aligning Departments with responsibility for health, well-being and education and tasked with making the navigation of treatment and support mechanisms easier for parents and young people alike using resources in this area to best effect. Both I and the Minister of State, Deputy Butler, look forward to how the work of the pathfinder project to date can be used to inform the youth mental health spotlight programme. I assure the Senator that I will continue to keep this matter under review in the context of progress to date or planned-for mental health legislation, policies and services relating to young people.
Paul Gavan (Sinn Fein)
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It is an extraordinarily long reply that tells me very little. The simple question at the heart of this Commencement matter is when will the pathfinder unit be set up? We are six years on from the recommendation and excuses are fairly thin. The Minister of State talks how about the establishment of the Department of Further and Higher Education, Research, Innovation and Science has necessitated some further consideration of the initial proposal. That was three years ago. What the Minister of State seems to be saying is that six years on from the recommendation to set up the pathfinder unit, she is not even in the position to tell me when it will be set up.
If that is the case, and it looks to be the case from the answer the Minister of State gave me unless she is able to give me a date in her response, that is an abject failure on the part of the Government. It is an abject failure on the part of the Government that is failing our young - our most vulnerable children and adolescents - and is entirely unacceptable.
Anne Rabbitte (Galway East, Fianna Fail)
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As I am deputising for the Minister of State, Deputy Butler, I cannot give the Senator a date and time. There is no doubt that the issues around youth mental health span many Departments and improved co-ordination in this area is needed. Improving access to youth mental health services for children and their families remains a priority for the Minister of State, Deputy Butler, the Minister, Deputy Stephen Donnelly, and the Department of Health. The fact that the pathfinder project is a programme for Government commitment also highlights how this Government is committed to ensuring that interdepartmental collaborative work is best used to ensure that mental health services are integrated, accessible and signposted.
While the Covid pandemic may have delayed the formal progression of pathfinder, I can confirm to the Senator that the important work on the delivery of its priorities has continued at pace. This can be seen in the establishment of the new assistant national director post of youth mental health and the inclusion of youth mental health as a spotlight project for the forthcoming national policy framework for children and young people. There will be further updates on this work as the year progresses.