Brian Walsh (Galway West, Fine Gael)
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Question 191: To ask the Minister for Health if he will consider the introduction of a formal protocol to facilitate the referral of patients with a history of mental health needs directly to a psychiatry unit instead of first requiring such patients to be assessed at an emergency department, which has been described by the Health Service Executive as the long-standing practice; and if he will make a statement on the matter. [20160/11]

Kathleen Lynch (Cork North Central, Labour)
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90% of all mental health needs are addressed in Primary Care with 10% being referred to specialist secondary care services. These services operate predominately in a community context with approximately 10% of the community caseload presenting requiring in-patient care admission. Over 20,000 admissions to mental health in-patient care occur each year and in each case the decision to admit is determined by a senior clinician following a detailed clinical assessment.

For individuals using community based mental health services, the first point of contact should be the Community Mental Health Team where they can be seen at a day hospital, community mental health centre, clinic or increasingly within the service users' own home. Where in-patient admission is indicated, a patient can be referred directly to their local approved centre for admission. If there is any concern relating to the person's physical health status, they may be encouraged to attend at the Emergency Department.

For out of hours emergency / crisis presentations a service user must access the Emergency Department where they can receive a psychiatric and medical assessment and offered in-patient admission where indicated. It should be noted that in-patient admission may not be the most appropriate course of action and direct access to acute psychiatric units would pose both operational and clinical risks. The protocol for accepting direct referrals is kept under review by local Executive Clinical Directors.