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Dáil
‹ Leaders' Questions

Mental health staffing and suicide prevention

Summary

Deputy O’Brien highlights unoccupied psychiatric beds, staff shortages and Ireland’s suicide rate. The Tánaiste outlines additional funding and recruitment, saying 383 of 414 approved posts are filled, offered or awaiting clearance, with further staff planned.

I would like to raise with the Tánaiste the growing concern about the delivery of mental health care provision, which is having a profound impact on some of our most vulnerable citizens, particularly young people. A recent report by the Inspectorate of Mental Health Services found that children and teenagers needing psychiatric care are being denied admission to facilities while beds within some of those facilities go unoccupied as a result of staff shortages. Depending on which report one reads, it is estimated that, at times, up to half of the beds in these facilities are not being utilised. This is at a time when there are growing waiting lists and waiting times for admission, in some cases of up to six months.

We have had cases where parents of vulnerable children are being asked to send their children from the Munster region to facilities in Dublin. In one such child and adolescent unit in Cork, for example, only 12 of the 20 beds available within that unit were being utilised last March. This was despite the fact that 15 people were waiting to be admitted on the day the inspectorate visited that unit. I am sure the Tánaiste will agree that is unacceptable. As recently as December, the mental health inspectors expressed concern over the welfare of a vulnerable child in the Cork area who was admitted to an adult psychiatric unit. They described the appalling situation where the child in question was left isolated in a bedroom, with no therapeutic intervention apart from medication.

What is being done to address the lack of psychiatric units for children and young people? What is being done to ensure child and adolescent psychiatric units have the necessary staff in place to allow the full utilisation of the beds available within those facilities?

Comment on this

It is fair to say the area of mental health has been an area of our health services which has not received sufficient attention. This Government, however, has decided to give the issues of mental health a very high priority and has given specific responsibility to the Minister of State, Deputy Kathleen Lynch, to address those issues. She is making very significant progress in improving the mental health services within our health system.

A special allocation of €35 million for mental health was announced in budget 2012. That was used primarily to further strengthen community mental health teams in both adult and child mental health services. Some 414 mental health posts were approved as part of budget 2012 and, as of 30 April this year, 383 posts have been filled, are under offer or are awaiting clearance. In addition, she has also dedicated funds to, in particular, advance suicide prevention initiatives and she has been working on that issue. She is taking the lead in committing to implement the recommendations of Reach Out, which is a national strategy for action on suicide prevention.

Right across the whole mental health area, a very significant amount of progress has been made by the Minister of State, Deputy Lynch. She is continuing, together with the Minister, Deputy Reilly, to work on the development of our mental health services, to give them the priority they deserve and to address the continuing challenges which we all acknowledge exist in the mental health area.

Comment on this

I thank the Tánaiste for his reply. He mentioned the 414 posts due to be filled and said that as of April 383 of them had been filled. When is it hoped the full allocation of posts will be completed? Also, it does not take into account retirements within that sector; therefore, I would be interested in knowing the net figure.

The Tánaiste mentioned the issue of suicide. I am sure he is aware of the recent report published by the charity 3Ts which made for shocking reading. Some of the statistics within it were very worrying. It indicated that Ireland had the fourth highest suicide rate in the European Union for those aged between 15 and 24 years. It is simply unacceptable to have a situation where facilities in place to help young children and adolescents suffering from mental health issues are not fully utilised. Does the Tánaiste accept that more needs to be done in providing counselling services for those at risk and their families, as well as the provision of information and education services? Can he give a commitment that the provision of funding for suicide prevention measures and mental health care services for young children and adolescents will be made a priority in the upcoming budget?

Comment on this

The question is in two parts. In respect of staff numbers, of the 414 posts approved in budget 2012, 383 have been filled, are on offer or are awaiting clearance. Progress is being made on the remainder. In budget 2013 a further €35 million was allocated for the development of mental health services. This includes the recruitment of 477 additional staff to implement these measures. I understand the HSE is making arrangements to commence the recruitment process very soon.

I welcome the Suicide in Ireland survey which was published on Monday. It is certainly a very welcome contribution to the debate on suicide. Some of the funding to which I referred will be used to advance further suicide prevention initiatives and initiate the provision of psychological and counselling services at primary care level specifically for people with mental health problems. The Minister of State, Deputy Kathleen Lynch, is committed to implementing the recommendations of the national strategy for action on suicide prevention. I am happy to be able to inform the House that the National Office for Suicide Prevention has implemented most of the recommendations in the strategy and reviewing its current activities to make the most of the available resources, including looking at best practice internationally.

Priority suicide prevention initiatives identified for this year include further development of existing national mental health awareness campaigns to promote help seeking, increased training for GPs and practice staff; building the capacity of communities to respond to suicide; implementation of the clinical care programme on self-harm which will include the funding of nursing posts within hospital emergency departments; training of acute hospital staff in suicide and self-harm intervention measures; the development of the SCAN model which allows for crisis interventions at primary care level; and continued investment in voluntary agencies providing services.

The annual budget for suicide prevention initiatives increased in 2012 to over €12 million. A total of €7.1 million is administered by the National Office for Suicide Prevention. This includes an additional €3 million from the special allocation for mental health services used to fund voluntary and statutory agencies delivering services in the areas of prevention, intervention and research. The remaining €5 million is available regionally to fund resource officers for suicide prevention, self-harm liaison nurses in hospital emergency departments and local suicide prevention initiatives. In 2013 a further €1 million is being provided for the National Office for Suicide Prevention, bringing the total available to over €8 million. A special programme of measures to further advance suicide prevention in 2013 is being developed and will be announced by the Minister of State.

Comment on this