James Browne (Wexford, Fianna Fail)
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799. To ask the Minister for Health the status of the implementation of each of the recommendations Nos. 15.1.1 to 15.1.9, inclusive, of a vision for change; and if he will make a statement on the matter. [34355/17]

Jim Daly (Cork South West, 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. The HSE budget for mental health services is over €850m this 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 are being developed for 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 of 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). Construction has recently commenced on site, to include a new 30 bed Intensive Care Rehabilitation Unit, with a view to the new facilities coming on-stream in early 2020.

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. 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 provide 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. Structured links to Divisional Gardaí level are also being developed. Good progress has been made in recent years on the specific recommendations, arising from the significant additional funding given to mental health, including the modernisation of the NFMHS and by progressing the work of the Inter Departmental Group on those with mental health issues coming into contact with the criminal justice system.