Colm Burke (Cork North Central, Fine Gael)
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288. To ask the Minister for Health if he will institute a campaign to assist young persons that have mental health challenges as a result of or exacerbated by Covid-19; and if he will make a statement on the matter. [19281/20]

Mary Butler (Waterford, Fianna Fail)
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The outbreak of COVID 19 throughout the world is a source of significant stress, anxiety, worry and fear for many people. This arises from the disease itself, as well as from impacts such as increased social isolation, disruption to daily life and uncertainty about employment and financial security.

The Government Action Plan in response to Covid-19, published on 16 March 2020, acknowledges the importance of people maintaining their wellbeing and resilience to push through this unprecedented outbreak. The Action Plan aims to reduce the risk of people becoming unwell and for those with a mild mental health issue, access to counselling and other interventions can provide much better positive outcomes.

 A psycho-social planning Group (HSE, DoH, NGO sector) has been established to plan for additional current and/or anticipated needs as post COVID.

In line with the WHO considerations, and the existing HSE guidelines, the Department of Health and HSE proposes a continuum of supports and a ‘stepped care’ approach to support the mental health and wellbeing needs of the population during and following the COVID 19 outbreak. This includes establishing strategies to ensure youth mental health is protected as schools prepare to re-open and exam results are disseminated. As part of the mental health response to COVID 19, a 4 step health approach is preferred:

1. A whole-population approach to raise awareness and promote mental health and wellbeing that will include additional supports for Junior and Leaving Certificate students. The Department of Health (led by Healthy Ireland team) and the HSE, in collaboration with key cross-Government and cross-sectoral partners, has developed a new mental wellbeing campaign.

2. Provision of life skills supports through Jigsaw online, youthreach and Foroige etc.

3. Provision of additional online supports such as counselling online through MyMind/Turn2Me etc.

4. Provision of online psychiatry supports for individuals with new/existing complex mental health needs (referral through primary care GP or Jigsaw).

The support services available for young people and families are listed on www.yourmentalhealth.ie and Gov.ie.

The HSE’s June Activity Performance Report indicates that residential and community mental health service activity has returned to close to pre-Covid levels.

The HSE, overseen by Dr Colm Henry (Chief Clinical Officer) and Dean Sullivan (Deputy Director General), is considering how to reintroduce/recommence services. Public health advice will guide the return to more comprehensive provision. Through its Business Continuity Plan, HSE Mental Health is considering ways to safely improve services in acute units, community residential settings and community teams, including telehealth technologies. Further engagement with NGO partners will maximise delivery through SLAs.

To plan for the ongoing and increasing need for mental health services, and the demand for more holistic person-centred responses across the whole community, the national mental health policy, Sharing the Vision, was published on 17th June 2020. The policy sets out a 10-year plan, including education, prevention and early intervention and additional access routes to treatment. The policy takes a lifecycle approach, and consequently includes recommendations for CAMHS services and positive mental health promotion for young people.  

The health service already has a range of proactive responses for any rise in service need. The Department and HSE continue to plan for any need surge as it arises and as services return to normal provision and capacity, subject to public health advice.

The Department of Health, with the HSE, will continue to monitor and maximise provision of CAMHS by the 71 CAMHS teams and 4 CAMHS inpatient units nationally for the remainder of the year, including HSE Service Plan activity levels. This ongoing performance monitoring will include full consideration of new approaches at national or local level to address waiting lists in an evolving Covid-19 situation.

The HSE has adapted provision of Child and Adolescent Mental Health Services (CAMHS) supports in Covid-19, and clinically urgent cases continue to be prioritised. CAMHS patients continue to access a comprehensive range of mental health supports specifically for Covid-19 issues, as appropriate.

The HSE Service Plan has a specific priority to continue to develop CAMHS inpatient and community-based services, and their integration with primary care services, as well as Talk Therapy and Child Mental Health Intellectual Disability teams.

The new HSE National Forensic Mental Health Service (NFMHS) complex at Portrane, recently used for Covid-19 purposes, will become operational early next year. This will involve the opening, on a phased basis, of the main forensic hospital, the Intensive Care Rehabilitation Unit and a forensic CAMHs Unit.

CAMHS Connect is a new e-mental health initiative to modernise mental health care nationally. The need for the potential roll-out of such a system nationally, in planning for some time, has been reinforced by Covid-19.

CAMHS Connect will improve access, reduce waiting times and address some staff recruitment and retention issues. Overall investment for the initial phase, the new Castlerea Mental Health Hub, is in the region of €2.6m.

Alongside the HSE’s YourMentalHealth.ie website, several state funded agencies have developed new ways of working during Covid-19. These include online support, additional telephone support lines and online training and peer support. These agencies are working with the HSE to determine future need based on uptake and are working with the HSE psychosocial response team on flexible responses to identified needs.

Paul Murphy (Dublin South West, RISE)
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289. To ask the Minister for Health the provisions that have been made in the regulations which require persons to wear face masks for those persons that for certifiable medical reasons are unable to wear facemasks. [19339/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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I would like to assure the Deputy that my Department appreciates the concerns around face coverings with regard to those who may not be in a position to wear them for medical reasons.

The National Public Health Emergency Team (NPHET) continues to examine all emerging evidence as it arises and has provided advice relating to face coverings on an ongoing basis. NPHET advises the wearing of a non-medical face covering in a number of circumstances including in retail outlets, by people visiting the homes of those who are cocooning, by people who are being visited in their homes by those who are cocooning, by visitors to residential care facilities and in indoor work environments where it is difficult to maintain a two-metre distance. I would again emphasise that the wearing of face coverings is an additional hygiene measure and should not take the place of good hand hygiene, respiratory etiquette and other personal protective public health measures. Face coverings should be used properly, in line with the guidance and with individuals washing their hands before putting them on and taking them off.

On Friday 10 July 2020, having consulted with the Minister for Transport, Tourism and Sport and the Minister for Justice and Equality, I signed the Health Act (Covid-19)(Face Coverings on Public Transport) Regulations 2020 (S.I. No. 244/2020). The regulations provide that, from 13 July 2020, members of the public (excluding children under the age of 13) shall not, without reasonable excuse, travel by public transport without wearing a face covering.

Reasonable excuse includes where a person:

- cannot put one on, wear or remove a face covering because of any physical or mental illness, impairment or disability or without severe distress

- needs to communicate with another person who has difficulties communicating

- removes the face covering to provide emergency assistance or to provide care or assistance to a vulnerable person

- removes the face covering to avoid harm or injury, or the risk of harm or injury

- removes the face covering to take medication  

The Regulations provide that a “relevant person”, defined as an officer, employee or agent of a public transport operator or of the National Transport Authority, who is responsible for the implementation of the Regulations and it is, therefore, a matter for the public transport operators and the National Transport Authority to make arrangements for what they consider necessary to ensure that such “relevant persons” are satisfied with the information provided by any individual who is using a public transport service.

As I am sure will be appreciated, the evidence relating to the SARS-CoV-2 virus and the discussion around face coverings is constantly evolving. The public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET), while the Government has now also agreed to the mandatory wearing of face coverings in retail outlets, shops and shopping centres. Retail staff will also be obliged to wear a face covering unless there is a partition between them and members of the public or where there is a distance of 2 metres between them and members of the public. The development of Regulations is this regard is underway and it is likely that similar “reasonable excuse” provisions will be included.

The Deputy may wish to note that the latest public health advice on face coverings is available at the following links and is updated on a regular basis:

www.gov.ie/facecoverings.

www2.hse.ie/conditions/coronavirus/face-masks-disposable-gloves.html.