Seanad debates
Tuesday, 21 November 2023
Nithe i dtosach suíonna - Commencement Matters
Mental Health Services
1:00 pm
Erin McGreehan (Fianna Fail)
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The Minister of State is very welcome. I am very glad the Minister of State responsible for this area is here. It is crucial that we address head-on the issue that no one should feel helpless and alone in circumstances where they have a mental health crisis. I ask the Minister of State to outline the supports available to an individual going through the trauma and also to family members who are trying to support that individual during that time. We all know that people do not plan to get sick. They do not expect it. Most of the time it comes out of the blue. As the Minister of State knows, mental health crises are often the same way. It is necessary to provide the necessary support and guidance to those individuals and families during these challenging times. I ask that we focus on establishing a comprehensive support system that is accessible to all in all circumstances. Often individuals and families are not sure where to seek health during a crisis. When they do go to the accident and emergency department and ask for that help, they should be able to receive it and not have to fight for it. Hospitals need more support workers and more trained professionals in order to help patients arriving at the doors, to be able to signpost and answer questions and to talk a family through what is happening.
Two stories have been highlighted to me recently by people in the constituency in which I live. Both the stories involve patients at Beaumont Hospital. One person had to fight tooth and nail to save her dad and convince doctors and psychologists that he warranted entry to a safe environment in order to get better. She begged to be heard and understood. She and her father were sent home with a list of ways to manage anxiety. No medication or intervention was provided. They were told to go to the GP. It began a very difficult time at home and a fight to survive. The person in question had to stay with her dad because she was incredibly worried, and rightly so. They called for an ambulance within 24 hours. The Minister of State can imagine how afraid and vulnerable her dad was, as she was herself. A doctor told her that her father had wasted resources and that he did not warrant the ambulance. Imagine hearing that from a medical professional. Even if it was not life and death at that moment, who was he to judge and to make a person feel more vulnerable?
Another young father was sent away because he was not in the Beaumont Hospital catchment area. He was promised that the matter would be followed up in the correct area but this never happened. Unfortunately and tragically, this young man took his own life, leaving a family in despair and a young child without a father. That in turn becomes a whole family trauma and leads to mental health difficulties.
The man in question was told by the doctor that he was not experiencing mental health difficulties. However, the doctor also mentioned that he was seeing an average of 20 people a day with mental health issues. These figures are shocking. The doctor saying he had wasted resources is more troubling as he also admitted to the man that he had only ever admitted two patients with mental health issues in his time in the accident and emergency department in Beaumont Hospital. The Minister of State gives a lot of resources. She is the most proactive mental health Minister of State we have ever had and has provided the largest budgets. She is putting out these policies and resources and but when a person goes to hospital, they lack advocacy and feel they are turned away at every opportunity. I have a few more questions but I will ask them in the follow-up.
Mary Butler (Waterford, Fianna Fail)
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I thank the Senator for raising this matter. I always look forward to coming to the Seanad and to any opportunity I can get to speak about mental heath and the fact that recovery is possible. Lived experience and what patients go through is something we have to listen to and learn from. That is important.
The answer that has been presented to me relates to crisis resolution services but I will speak in general first. One in four people, at some stage in their life, will have an issue with their mental health.Thankfully, we are speaking more openly and more freely about it now. For many people, a visit to their GP and the support received from there can be sufficient, but there are other people who may have an acute mental health episode which might require a great deal of help, which is why we have more than 68 approved centres in the country, which are departments of psychiatry. These are for people who would have an acute mental health challenge and who need support. It is important people reach out for those supports because, unfortunately, in Ireland, we are seeing that three quarters of all suicides in Ireland are men and one quarter are female. I am very conscious of the fact that Sunday was International Men's Day and this is International Men's Health Week. A very significant proportion of people, men in particular, who need supports are not reaching out. That was not the case being presented by the Senator today and I cannot speak to an individual case. In this case, men of different ages reached out for help and they felt the help they got was not sufficient.
On 26 May this year, I launched the crisis resolution services model of care. It represents a significant step forward in the provision of targeted mental health supports for people experiencing a crisis. It also fulfils a long-standing goal, aligning with a number of recommendations in Sharing the Vision, our national mental health policy. Our national mental health policy puts the service user front and centre. It is cross-departmental because if a person has issues outside of his or her health or issues with regard to housing, social protection or justice, it can trigger a mental health episode.
The demand for a crisis resolution services model of care arose from the recognition that those experiencing mental health crises often require specialist supports after hours and at weekends. It offers person-centred intensive supports in a timely way to assist the service user in his or her recovery journey. Importantly, it seeks to offer an alternative to inpatient admission. The national crisis resolution service steering group was responsible for overseeing and advising on the design and development of a model of care and pilot implementation plan. Membership included representatives from each location and national representatives such as psychiatry, social work, occupational therapy, psychology, nursing, mental health operations, mental health planning, etc.
Crisis resolution teams are community-based multidisciplinary teams that provide rapid assessment and intensive support to individuals who are in a mental health crisis, working rapidly and co-operatively to help people in a mental health crisis. This pilot scheme sees the incorporation of the teams in five different pilot learning sites: CHO 1, CHO 4, CHO 5 and CHO 6, and a fifth site due to open in quarter 4 of 2023. The reason these particular areas were picked is that these were identified as areas with very poor supports out of hours. The other areas would have been deemed as having supports out of hours. Crisis resolution teams will also play a role in supporting out-of-hours crisis cafés, or solace cafés. They will provide a friendly and supportive crisis prevention and response service. They will run in partnership with different community agencies. I will continue my contribution in my next part.
Erin McGreehan (Fianna Fail)
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I thank the Minister of State for her genuine and thoughtful answer. Our basic requirement for patients when they have these crisis moments is to trust the system and to feel safe. That is a step to recovery and to being able to trust that system. A key point, particularly when the Minister of State's Department is doing so much in the area, is that it needs to filter down to the accident and emergency department. When I googled what to do in an accident and emergency department and what the best advice for me is, there was nothing or any advice for me. Nothing came up for me. When a person is in crisis, who does that person do to ensure they are not dismissed and do not feel inferior, a nuisance, unheard or that they are going crazy because nobody is listening to them? We must offer and make this service a far better one when somebody presents to an accident and emergency department.
I know the Minister of State is so committed to this because we have had conversations with her before about this. It is something on which I would very much like to work with the Minister of State to be able to understand as a local representative, to be able to help signpost my constituents and to give them the support the Minister of State is putting in place.
Mary Butler (Waterford, Fianna Fail)
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I thank the Senator. She has a good point which many of her colleagues make every day in the Dáil and Seanad. The first port of call for anybody who is in distress should always be the GP. Always reach out to somebody in your family, if you can at all. So many people do not reach out. If the GP or an ambulance is called, you will be brought to the emergency department.It would be expected that, within a short space of time, you would be seen by somebody with a psychiatric background to conduct an assessment. That is the most important thing. It is also important that people realise recovery is possible. In the HSE at the moment, there is a new group which is recovery and education-focused. Everyone working there has lived experience of mental health difficulties. We include peer support, which is important.
I am happy to speak to the Senator offline about the two cases she raised to see if I can do anything to help. All I can say to people is please reach out if they need help. I know in these cases people reached out but they felt sufficient help was not provided. I am very sorry that was the case.