Cian O'Callaghan (Dublin Bay North, Social Democrats)
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2410. To ask the Minister for Health if she will examine alternative options for people suffering from a mental health crisis in order that they do not need to go through the standard accident and emergency department; and if she will make a statement on the matter. [20738/25]

Mary Butler (Waterford, Fianna Fail)
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People experiencing mental health distress and illness often find busy Emergency Departments - especially out-of-hours - the wrong setting for their needs, and we know this is the reason some people leave before meeting a clinician.

Minister Butler recently welcomed the report of the Chief Inspector of the Mental Health Commission into acute mental health care in hospital Emergency Departments, stating that her priority is that people in mental health crisis are provided with timely assessment and support in an appropriate environment that keeps them safe.

Minister Butler recently expressed her impatience to the HSE at the pace of change, nothing that the Mental Health Commission’s report is a timely reinforcement of the need for the department and the HSE to intensify efforts to expand access to these alternatives to Emergency Departments.

A number of initiatives have been launched since the publication of Sharing the Vision: A Mental Health Policy for Everyone to develop real alternative care pathways and therapeutic environments to reduce the number of people who have to attend Emergency Departments for acute care. This includes deliver investments and implementation of the National Clinical Care Programme for the Assessment and Management of Patients presenting to Emergency Departments following Self Harm, which relates to policy Recommendation 23.

Supports have been put in place so people presenting to emergency departments (EDs) receive a compassionate response, as well as a therapeutic assessment and intervention from a suitably trained mental health professional. This programme is delivered in all 26 adult emergency departments that are operating 24/7 and in one paediatric hospital.

The Model of Care for Self-Harm and Suicide Related Ideation was updated in 2022 and incorporates the Suicide Crisis Assessment Nurse (SCAN) service, which provides a critically important safety net for people in suicidal crisis. The ambition of the new Sharing the Vision implementation plan (2025-2027), published on 9th April 2025, is to expand these services to provide full coverage nationwide. The SCAN service provides a timely response to requests for assessment of patients in suicidal crisis from GPs, and the assessments often take place in primary care settings. In addition, Budget 2025 provided funding for a further six SCAN nurses, and work is ongoing to ensure full access to the service across the country.

The model of care for the service envisages a dedicated mental health assessment room within hospitals to provide a more appropriate environment for assessments to take place. Given most acute mental health in-patient units are co-located with our acute hospital network, it is important that people in distress are assessed in clinically appropriate environments when they present for support.

Over the course of the second implementation plan for Sharing the Vision, a new National Clinical Programme for Self-Harm and Suicide Related Ideation will be published and will include a scaling up of the Suicide Crisis Assessment Nurse service. To support this continuous service improvement, an online data capture tool will provide valuable insights into population needs, service user experiences and the effectiveness of the service.

The policy also commits to providing an alternative to emergency departments for people in a mental health crisis. The emergency department is not an appropriate environment for supporting people in distress, and work is ongoing to shift supports for those in crisis away from hospitals and into services in our communities.

The development of the new model of care for Crisis Resolution Services has been delivered, which has two components::

Crisis Resolution Teams: teams of mental health professionals who work out of hours to meet people in a crisis and provide rapid assessment and intensive intervention.

There are five pilot Crisis Resolution Teams currently operational in Sligo/Leitrim, Cork city (two teams), Waterford City and County, South Dublin/Wicklow. The Limerick Crisis Resolution Team is due to commence operations later this month (April).

Crisis Cafés: a welcoming, non-clinical safe environment in the style of a café where people can go at evenings and weekends. These are known as 'Solace' cafés, and a number are now open in different locations.

The model of care for Crisis Resolution Services was developed as a direct recommendation of Sharing the Vision (Recommendation 24). It recognises that people who are experiencing a mental health crisis need specialist services to provide timely brief intensive supports to keep people safe. Work is ongoing with the HSE to speed up the expansion of these services for people in a mental health crisis.