Louis O'Hara (Galway East, Sinn Fein)
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1170. To ask the Minister for Health to outline her plans to provide an alternative to accident and emergency for people experiencing a mental health crisis; if this will be included in her Department's plan 'Sharing the Vision: A Mental Health Policy for Everyone' Implementation Plan 2025 - 2027'; and if she will make a statement on the matter. [24255/25]

Louis O'Hara (Galway East, Sinn Fein)
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1171. To ask the Minister for Health if her Department will ensure that mental health records of people presenting to accident and emergency experiencing a mental health crisis are immediately referenced upon arrival; her plans to ensure that they are secured and monitored once they have presented; and if she will make a statement on the matter. [24256/25]

Mary Butler (Waterford, Fianna Fail)
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I propose to take Questions Nos. 1170 and 1171 together.

It is widely accepted emergency departments are an inappropriate environment for people in a mental health crisis, and that alternative care pathways and therapeutic environments should be developed. People experiencing mental health distress and illness often find busy Emergency Departments the wrong setting for their needs and evidence indicates this is often the reason some people leave before meeting a clinician.

Supporting the development of real alternatives to emergency departments is a priority for Government: the Department of Health and the HSE continue to work to expand alternative care pathways and therapeutic environments for people presenting to emergency departments in mental health crisis, and to prioritise securing additional funding to continue their expansion. The Government remains firmly committed to enhancing all aspects of mental health services. The total allocation for mental health services is just under €1.5 billion for 2025.

On 9th April 2025, I launched the Sharing the Vision: A Mental Health Policy for Everyone Implementation Plan 2025 - 2027 at Dublin Castle. This document contained a number of commitments to enhance supports provided in Emergency Departments, such as ensuring the provision of appropriate environments for those presenting to Emergency Departments in mental health crisis, and ensuring continued investment in the National Clinical Care Programme for the Assessment and Management of Patients Presenting to Emergency Departments Following Self-Harm.

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 delivery 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 acute mental health 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:

1) 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 six pilot Crisis Resolution Teams currently operational in Sligo/Leitrim, Cork city (two teams), Waterford City and County, South Dublin/Wicklow and Limerick.

2) 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.

In addition, a Community Access Support Team (CAST) has been developed in Limerick City. This is a partnership between An Garda Síochana and the HSE to establish an appropriate co-response approach to calls relating to mental health and situational trauma. The CAST team are working to enhance diversionary practices for those experiencing crisis and situational trauma that leads to mental health difficulties, with the shared goal of providing a compassionate and effective response to people in distress and improving their experience and outcomes.

The Child & Youth Mental Health Office published a 3-year action plan in February of this year which commits to developing an Integrated Crisis Response Pathway for children and young people experiencing a mental health crisis across the 24/7 continuum of care, including an improved child and youth liaison service with Emergency Departments.

The Department of Health and HSE will continue to advance initiatives that will improve the supports available to all those in Mental Health crisis, guided by policy.

As your question above references specific operational matters, regarding the management of mental health records and the monitoring of those who presents at Emergency Departments, I have referred this correspondence to the HSE for direct response on these matters.