Written answers

Tuesday, 8 July 2008

Department of Health and Children

Mental Health Services

11:00 pm

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 266: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to invest in and fully implement the Vision for Change Strategy and provide further additional funding to support the recovery model of mental health service provision; and if she will make a statement on the matter. [26784/08]

Photo of Dan NevilleDan Neville (Limerick West, Fine Gael)
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Question 418: To ask the Minister for Health and Children if further to her statement of 8 May 2008, in which she expressed her concern that the resources allocated to the Health Service Executive to implement the recommendations contained in A Vision For Change were not spent for the purposes voted by Dáil Éireann, she will inform the Houses of the Oireachtas of the outcome of her discussions with the Health Service Executive regarding same and explain the reason the HSE did not consult with her of its decision to re-direct the funding from the purpose for which it was allocated. [27794/08]

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
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I propose to take Questions Nos. 266 and 418 together.

The estimated additional cost of the implementation of 'A Vision for Change' the Report of the Expert Group on Mental Health Policy is €150m over 7 to 10 years. A total of €51.2 million has been allocated since 2006 which represents over a third of the overall requirement. In addition to the extra funding required to finance 'A Vision for Change', existing resources need to be remodelled and reallocated. It is clear that the implementation of the report is dependent to a much greater extent on the remodelling of existing resources, than on new additional funding. It is also clear that additional investment must be phased in parallel with the reorganisation of mental health services and resources. In view of the significant additional investment in 2006 and 2007, it is necessary to pause and review the situation in 2008, to ensure consolidation of the investment to date.

Substantial resources have been invested in mental health services. Estimated expenditure in 2006 and 2007 was €984 million and €1 billion respectively. It is also important to bear in mind that some 90% of mental health services are provided at primary care level. Expenditure on these services is not captured in the above figures.

The Department of Health and Children has been advised by the HSE that €24 million of the €51.2 million development funding was not used as planned, because of competing expenditure pressures and the overriding obligation on the HSE to live within its overall Vote. As a result, some of the planned developments in mental health services have been delayed; however, some of the mental health services funded in 2006 and 2007 will be put in place in 2008. These include the provision of 8 additional child and adolescent mental health teams, and the provision of 18 additional beds for children and adolescents at St. Anne's, Galway, St. Vincent's, Fairview and St. Stephen's Hospital, Cork, to increase the bed complement from the current provision of 12 to 30 during 2008.

Implementation of 'A Vision for Change' is a key priority for the recently established Office for Disability and Mental Health. The Office is working in partnership with the HSE and other stakeholders to achieve implementation of agreed targets.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 267: To ask the Minister for Health and Children the progress made in relation to the Government commitment to ring-fence funds from the sale of existing mental hospitals, estimated to be approximately €800 million, to fund community based services; the breakdown of moneys ring-fenced to date; the amount of this money reinvested in community based services; and if she will make a statement on the matter. [26785/08]

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
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A Vision for Change, the Report of the Expert Group on Mental Health Policy has been accepted by Government as the basis for the future development of our mental health services. The Report recommends inter alia that a plan to bring about the closure of all psychiatric hospitals should be drawn up and implemented, and that the resources released by these closures should be protected for reinvestment in the mental health service. It is understood that the Health Service Executive (HSE) has disposed of a small number of assets since the launch of the Report in January 2006.

As the HSE has primary responsibility for implementing this recommendation, the Executive is the appropriate body to consider the particular issues raised by the Deputy. My Department has requested the Parliamentary Affairs Division of the Executive to arrange to have the matter investigated and to have a reply issued directly to the Deputy.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 268: To ask the Minister for Health and Children the progress made in relation to the Programme For Government commitment to increase the number of postgraduate training places for clinical psychologists; and if she will make a statement on the matter. [26786/08]

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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To qualify as a clinical psychologist, a post-graduate qualification in clinical psychology must be completed after an initial undergraduate degree in psychology. Post-graduate students are sponsored by health agencies and spend time over three years in clinical placements in different specialties; course work and a thesis must be also satisfactorily completed.

For some years the Health Service Executive has been committed to developing the number of postgraduate training places for clinical psychology nationally. In 2003, the total training places available nationally was 54. At that time, clinical psychology training opportunities were available at UCD and TCD only. Since then, facilitated through a partnership initiative involving the HSE and four National Universities — TCD, UCD, UL and NUIG — the number of clinical psychologists in training has doubled to 110 training places. Within the HSE, a Working Group continues to examine the issue of training places and I have been advised that the Executive aims to bring the total number nationally to 150 by the year 2009.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 269: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to provide community alternatives to psychiatric in-patient care for young people with special education needs; and if she will make a statement on the matter. [26787/08]

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
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A Vision for Change — the Report of the Expert Group on Mental Health Policy proposes a holistic view of mental illness and recommends an integrated multidisciplinary approach to addressing the biological, psychological and social factors that contribute to mental health problems. It recognises that responding to children's mental health needs can be conceptualised at different levels, ranging from early intervention and health promotion programmes, to primary and community care services and specialist mental heath services for the treatment of complex disorders. Recommendations in the Report are consistent with commitments in the Programme for Government.

Implementation of A Vision for Change is the responsibility of the Health Service Executive (HSE). In this regard the HSE has prioritised the development of child and adolescent services in 2008 and has recently advertised 12 Consultant Child and Adolescent Psychiatrists posts; teams to support the consultants are also being advanced. In addition the HSE propose to increase the in-patient child and adolescent bed capacity from the current number of 12, to 30 by the end of the year. Construction will also begin on two purpose-built 20 bed children's in-patient units in Galway and Cork.

It is noted that considerable work in planning the reconfiguration of mental health services for people with an intellectual disability was undertaken in 2007 following the Report of the Forum on Mental Health and Intellectual Disability. In 2008, each area will be required to agree the reconfiguration necessary to meet the recommendations in relation to the provision of services for people with Intellectual Disability. As the majority of services for people with intellectual disability is provided by voluntary partners, these arrangements will be agreed and developed jointly with the voluntary partners.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 270: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to implement, as a matter of urgency, the recommendations of Reach Out and the recommendations of the Joint Sub-Committee on the High Level of Suicide; her views on the fact that the National Office for Suicide Prevention received no additional funding in 2008; and if she will make a statement on the matter. [26788/08]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 271: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to adopt a target of reducing the rate of suicide by 20% by 2012; and if she will make a statement on the matter. [26789/08]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 272: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to develop initiatives to target persons most at risk of suicide, promote well-being, raise awareness and reduce stigma; and if she will make a statement on the matter. [26790/08]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 273: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to increase the range of supports to families and communities affected by suicide and bereavement; and if she will make a statement on the matter. [26791/08]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 274: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to collate accurate data on suicide and conduct and fund research on prevention methods; and if she will make a statement on the matter. [26792/08]

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
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I propose to take Questions Nos. 270 to 274, inclusive, together.

In September 2005, Reach Out — a National Strategy for Action on Suicide Prevention, 2005-2014 was launched. The strategy provides a policy framework for suicide prevention activities in Ireland. The strategy calls for a multi-sectoral approach to the prevention of suicidal behaviour in order to foster cooperation between health, education, community, voluntary and private sector agencies. The actions identified in this strategy are consistent with the commitments in the Programme for Government. The HSE, through the National Office for Suicide Prevention (NOSP), oversees the implementation of the strategy and has taken on board the recommendations of the Joint Committee on Health and Children regarding the "High Levels of Suicide in Irish Society" which are consistent with the actions identified in Reach Out.

One of the key components of the overall strategy aimed at reducing suicide include the implementation of measures aimed at high risk groups, provision of information and training on suicide prevention to relevant professionals and organisations, research on suicide prevention and the improvement of services which would benefit those at risk of suicide and those who attempt suicide. Suicide prevention rates have been agreed with the National Office for Suicide Prevention — an interim target for a 10% reduction in suicide is to be achieved by 2010. In addition, a target of 5% reduction in repeated self- harm by 2010 and a further 5% by 2016 has been set.

Additional funding of €1.85 million was provided in 2007 for the implementation of the Strategy bringing the overall funding available to support suicide prevention initiatives in 2007 to €8 million and this level of funding continues into 2008. This funding is being used to develop and implement national training programmes, complete the availability of self-harm services through A&E departments, develop mental health awareness campaigns, implement recommendations arising from a review of bereavement services and support voluntary organisations working in the field of suicide prevention.

It should also be recognised that a range of services such as mental health and primary care services are important in helping to prevent suicide. These services play a vital role in the drive to reduce the incidence of suicide and should be taken into account when considering the level of expenditure devoted to suicide prevention.

The promotion of positive mental health contributes significantly to combating ignorance and stigma which often surrounds mental illness. In 2007, two national mental health awareness campaigns were launched. In October 2007, the HSE's National Office for Suicide Prevention's Mental Health Awareness Campaign 'Your Mental Health' was launched. The main aim of this campaign is to influence public attitudes to mental health and is specifically designed to alter negative attitudes and to promote positive attitudes and a greater understanding of mental health. In addition, in December 2007, the National Disability Authority launched an advertising campaign 'Challenging Attitudes to Mental Health', which is designed to challenge negative perceptions about people with mental health problems.

The NOSP Annual Report includes details on initiatives and statistics etc. including research activities funded.

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