Will the Taoiseach please respond to the news that the Psychiatric Nurses Association, PNA, has voted by a staggering 87% to take strike action over staff shortages in the mental health services, particularly among psychiatric nurses? The famous report, A Vision for Change, dates back to 2006 and recommended an increase of 1,800 staff in mental health services. By 2012, we were 23% below that recommendation. In 2014, the suicide rate was 475. That figure does not include the numbers who attempted to take their own lives or did themselves harm because of the continuing deprivation in mental health services.

The reason the PNA gives for this serious ballot on strike action is that there is no clear plan from the Health Service Executive, HSE, on how to address this staffing crisis. Staffing levels in child mental health services are down 50% and the staffing level in adult mental health services is only 75% filled. The PNA says that there are 600 vacancies for psychiatric nurses and there will be another 400 within the next year because of retirements. To stay at the current level would require an extra 1,000 nurses in the mental health services. That does not include child psychiatrists and other therapists required.

The Taoiseach will be asked many questions later about the programme for Government, but I want to use this opportunity to ask what the programme intends doing in this regard because in the mental health section it states it will implement A Vision for Change.

Given the level of crisis in terms of staff shortages and funding for mental health services alone, can the Taoiseach outline for the House what answer he will give to the Psychiatric Nurses' Association, PNA, the mental health services generally and those who require mental health services to address the chronic shortage in the service? It seems to me that the programme for Government and HSE are failing to address this urgent crisis.

Deputy Smith has raised an important question. That is why the Government made clear this morning that the extra allocation to the Estimate for the Department of Health and the HSE will restore in full the ring-fenced moneys for mental health services. The details of how they are to be located and spent will be outlined by the Minister of State, Deputy McEntee, and the Minister, Deputy Harris, over the course of the discussions on the Estimates next week and the week after.

It is fair to say that there are some serious recruitment issues in respect of the problem to which the Deputy referred. The Minister and Department are examining that question. I can stand here and say that because of the increased strength in the economy, an adjustment will be made to deal with what was set out in the programme in terms of the allocation for the mental health area.

I spoke to people the other day with regard to the Department of Children and Youth Affairs. I find there is always a complication between psychologists and psychiatrists working for the HSE and Tusla when children might need services and things are to be contracted again. The legal costs arising in areas surrounding children are always significant.

Suicide and self-harm are very traumatic and sensitive issues that exist not just in any particular location in the country, but across every area. The clinical programme for the assessment and management of self-harm in emergency departments provides a skilled response to people presenting with self-harm issues or suicidal ideation, as it is called, in emergency departments through a network of self-harm psychiatric nurses. Some 24 of the 35 additional nurses available have been recruited to this programme and trained for the role, and are doing a very important job, as the Deputy is aware.

The HSE is committed to further developing early intervention and prevention services. I hope the extra allocation being made to the health area and the restoration of funding for the mental health area will benefit these persons greatly. The details will be outlined by Ministers over the next week or so.

The period I outlined, in which there was an ever-increasing shortage of staff in mental health services, was also a period of austerity, when economic hardship and worries such as where to live, job losses, putting a roof over one's head, sending children to college, etc., put a major stress and strain on people, which led to further loss of mental health in families, the self-employed and unemployed workers.

The period to which I referred, when there was a reduction in psychiatric nurses in particular, is the one on which the PNA is focusing. The Taoiseach has failed to address my question. If the PNA takes strike action on the issue of nurse shortages and the need to recruit at least 375 extra psychiatric nurses per year for the next few years, where will the money and determination come from?

The Taoiseach answered Deputy Martin's question about the extra funding that has been allocated to health, and said it would be allocated to existing services, overruns in acute hospitals, disability, home help services and mental health. Many areas require funding before one even begins to examine the need to engage an extra 1,000 psychiatric nurses, according to the PNA, which is taking strike action because of that fact.

I apologise to Deputy Smith for not addressing her question. Obviously, I hope industrial action will not take place. The Minister for Health met the association last Friday and is engaging with it. Some of the issues that are being considered are the possibility of more training places for psychiatric nurses, bringing back a number of recently retired psychiatric nurses and continued efforts to attract nurses who have been working abroad back to Ireland This is a genuinely serious problem and one that the Minister is working hard to grapple with.

In 2015, almost 30,000 people were offered a first appointment and seen under A Vision for Change, the mental health strategy. As Deputy Smith is aware, every emergency department has 24-7 access to mental health services. Consultant psychiatrist and non-consultant hospital doctors in psychiatry working in general adult and old age psychiatric services, together with liaison psychiatry medical staff, provide an on-call service outside normal working hours. It is largely focused on people presenting with urgent mental health problems.

The Government made a decision to adjust the Estimate in respect of the health Vote. Funding for the mental health area is being fully restored. Details will be outlined by Ministers and I am quite sure that the Deputy's input will be valuable to what is a serious argument.