Anne Rabbitte (Galway East, Fianna Fail)
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67. To ask the Minister for Health his views on comments made by the Office of the Ombudsman for Children that it is disappointed with the lack of progress in relation to young persons struggling with serious mental health issues that are trying to access the emergency supports they need. [28320/18]

Jim Daly (Cork South West, Fine Gael)
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One of the Government’s priorities is ensuring appropriate and accessible mental health services for children to ensure that needed services are provided as close as possible to the patient and in the most accessible manner.

It is the policy of the HSE, in its annual Service Plan, to provide an age appropriate mental health service for those under age 18. Mental Health remains a key care programme priority for this Government. This is reflected by a Budget 2018 allocation of an additional €35 million for new developments, bringing the total HSE mental health budget to over €910 million.

The HSE Service Plan 2018 commits to further development of Child and Adolescent Mental Health Services (CAMHS). This is a Strategic Priority Action in the Plan, against a background where the population of children is expected is increasing, and where the demand for CAMHS has seen a 26% increase between 2012 and 2017. Around 18,800 referrals are expected for HSE CAMHS this year, with about 14,300 being seen by this specialist service.

CAMHS has been prioritised in new funding made available by Government over recent years. Additional resources and facilities means there are now 69 CAMHS teams, and 3 Paediatric Liaison Teams, supported by around 75 CAMHS beds nationally, with further beds planned to come on-stream in the near future.

There has been widely acknowledged difficulties in recruiting and retaining specialist CAMHS staff, particularly Consultant Psychiatrists.

The HSE is working to provide the best possible service within available staffing resources.  A key focus is on managing clinical risks and prioritising referrals accordingly.  Mental health services, including CAMHS, will continue to deliver on a number of service improvements to increase productivity and efficiencies. A key approach to developing services for young people, and thereby reducing pressures on CAMHS, is the decision by Government to increase access to counselling services in Primary Care, with the appointment of 114 Assistant Psychologists and 20 Psychologists. These key staff are now being put in place nationally by the HSE.

Other CAMHS specific measures included in the HSE Service Plan 2018 includes:

- An initiative to increase the number of CAMHS referrals to be seen this year by 27%, compared to 2017;

- Provide for a seven day per week service for CAMHS to ensure supports for young people, in line with Connecting for Life;

- Improve Day Hospital services within CAMHS; and

- Develop Eating Disorder specialist community teams for young people.

The HSE is also focussing on enhanced access by older adolescents to specialist mental health services, along with continued appropriate placement and care in CAMHS specific settings.

My Department has set as a priority with the HSE, the development of a 24 hour helpline and digital support services.  These services will provide for easier access to supports and where appropriate early and urgent interventions using innovative digital technologies.

The Minister is introducing a telepsychiatry pilot project to ascertain the merits of delivering care from a distance using technology and videoconferencing. Telepsychiatry can provide a range of services including psychiatric evaluations, individual, group and family therapy, education and patient management.  There is substantial evidence regarding the effectiveness of telpsychiatry and research indicates a high level of patient satisfaction, especially among adolescents and those with autism and severe anxiety disorders.

There are many types of mental health services available in Ireland and it can be difficult to understand what service is most suitable to address an individual’s needs. Minister Daly has prioritised the establishment of a 24/7 signposting telephone mental health line service as a single point of contact to assist people locate and be referred to appropriate mental health services in their area.

Minister Daly is working closely with the HSE to develop a crisis digital texting service for those who feel that they are in need of urgent support. People will be able to text a specific number monitored by a trained counsellor responding from a secure online platform. A trained volunteer can then be assigned to the caller to assist the individual immediately. Following the call or texting conversation, appropriate referrals and follow-up work begins.

Every effort is being made to address the important issues raised in the Ombudsman's report, including prioritising cases based on professional assessment. My Department will continue to closely monitor the issues raised, in conjunction with the Health Service Executive.