Written answers

Tuesday, 6 December 2016

Department of Health

Mental Health Services Report

Photo of James BrowneJames Browne (Wexford, Fianna Fail)
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311. To ask the Minister for Health the status of the implementation of each of the recommendations of 15.1.1 to 15.1.9, inclusive, of a Vision for Change; and if he will make a statement on the matter. [38425/16]

Photo of Helen McEnteeHelen McEntee (Meath East, Fine Gael)
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Significant progress has been made on implementation of A Vision for Change, underpinned by the substantial additional funding provided by Government since 2012. Including funding agreed in the recent Budget, the HSE budget for mental health services will be in the region of €850m next year for mental health. All aspects of adult and child and adolescent services are being developed, including acute and community based services, along with forensic mental health services. Detailed service improvements are reflected each year in the HSE National Service Plans and the HSE Mental Health Division Operational Plans, available on the HSE website.

The HSE National Forensic Mental Health Service provides specialist forensic services to those referred from the Irish Prison Service, and the Youth Justice Service. It also provides consultation and advice to An Garda Síochána, and the Courts Service of Ireland. Every effort is made to ensure that forensics mental health care provision is in accordance with the recommendations of A Vision for Change, including legal considerations and person-centred and recovery-based approaches on an inter-agency basis.

In relation to Recommendation 15.1.1, all prisoners are medically assessed on committal to prison. This includes a mental health assessment which can be employed to develop an individual care plan. Where clinically indicated, the prisoner is referred to a forensic clinician who, subject to his/her findings, may make certain recommendations to the Governor for the care of the prisoner. Prisoners on release, are entitled to be referred to the HSE mental health services in the normal way.

In regard to 15.1.2, the National Forensic Mental Health Service (NFMHS) at the Central Mental Hospital (CMH) at Dundrum provides a Mental Health Prison In-Reach and Court Diversion Service (PICLS) programme to the Irish Prison Service. The diversion system ensures as far as possible that those people presenting before the courts, or indeed at an earlier stage of the criminal justice system, where the infraction is a reflection of an underlying mental illness, are referred and treated appropriately. This approach has reduced the number of mentally ill people committed to prison, under sentence. An Interdepartmental Group is looking at what further improvements can be made on the issue of persons with mental illness and their interaction with the Criminal Justice System.

The recommendation reflected in 15.1.3 refers to increasing community based forensic mental health teams. Full multi-disciplinary teams will be established in 2017 connected to Castlerea, Limerick and Cork prisons.

Planning permission for a new modern Forensic mental health facility in Portrane to replace the Central Mental Hospital in Dundrum, was granted in June 2015. Phase 1 of the project comprises a new 120-bed hospital, as reflected in Recommendation 15.1.4, along with a new 10-bed Child and Adolescent Mental Health unit (Recommendation 15. 1.6) and a new 10-bed Mental Health Intellectual Disability unit (Recommendation 15.1.7). I was pleased to secure the significant additional capital funding in Budget 2017, to allow construction to commence on Phase 1 early next year, with a view to the new facilities coming on-stream in 2019. Phase 2 of the project envisages the provision of regional Intensive Care Rehabilitation Units, as resources allow over the longer term.

In relation to 15.1.5, there are a number of prison based multi-disciplinary groups that provide information and support in the area of mental health to prisoners. There are consultant-led forensic mental health in-reach teams in all the prisons in Ireland at present except for Castlerea where it is hoped to provide an appropriate service in early 2017. The Irish Prison Service (IPS) is seeking to advance a robust system that would see integration and further development of services with statutory and voluntary partners. Mental health service provision in prisons must form part of the overall community response to this cohort of prisoners. Current arrangements with the Central Mental Hospital are a good example of collaborative working. In addition to healthcare input, the IPS Psychology Service provides ongoing evidence informed therapeutic approaches to those referred to the service who are suffering from mental health difficulties.

The implementation of Recommendations 15.1.8 and 15.1.9 are being progressed on a joint basis by the health and judicial systems. This involves, for example, the HSE National Forensic Mental Health service, An Garda Síochána and the Irish Prison Service. The NFMHS provides regular training to An Garda Síochána and the Garda training college at Templemore also delivers training as part of the training of all new Garda trainees. The Forensic service provides an advisory service to the Garda negotiation team, and has established links to local gardaí. In 2017 it is planned to develop structured links to Divisional gardaí. Good progress has been made in recent years, arising from the significant additional funding given to mental health, including the modernisation of the NFMHS and by progressing the work of the Interdepartmental Group on those with mental health issues coming into contact with the criminal justice system.

I recently commenced a review of all aspects of A Vision for Change, to help inform policy and service development in the future. In this regard, I will bear in mind the issues raised by the Deputy.

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