Mental health and Linn Dara beds
Deputy Micheál Martin presses the Taoiseach on the crisis in mental health services, then focuses on the planned closure of 11 child and adolescent beds at Linn Dara and the lack of alternatives for affected families. The Taoiseach says funding and recruitment have increased, insists the issue is staffing rather than money, and says efforts are under way to keep the unit open.
I raise again with the Taoiseach the growing crisis in the mental health services. This is occurring for a combination of reasons, including the cutbacks of recent years and a major issue with retention and recruitment of nursing staff, psychologists and psychiatrists. There has clearly been a lack of strategic planning on the human resources side for some time. This is having a significant and damaging impact on people with mental health issues, particularly children. Across the country, it has never been as difficult to access mental health services. One example, which was brought to the Taoiseach's attention by Deputy James Browne, was that of people being treated on chairs in corridors in Waterford. In that case, it involved a young 16 year old in an adult ward.
A case has been brought to my attention by another Deputy concerning the hinterlands of Dublin where a patient presented at an emergency department with a general practitioner's letter saying that he was suicidal. He was simply put on anti-depressants and discharged without admission.
There are bed shortages and staff shortages and the situation is becoming alarming, as illustrated by the news that the Linn Dara child and adolescent mental health service, CAMHS, inpatient unit, a children's mental health facility in Cherry Orchard, is closing 11 of its 22 beds from Friday next for the summer due to staff shortages. We have had correspondence, including emails, from parents of patients at Linn Dara who are under enormous pressure. Children who were admitted two weeks ago at high risk and in need of emergency admission are now being discharged early. Parents have asked us where are they to go next Friday. Why is the HSE saying that the facility will re-open in September? It does not add up that there will be shortages in June but they will be sorted in September.
While there are meant to be 100 child and adolescent beds, there are 63 at present and that will decrease to 52 with what is happening at Cherry Orchard. Deputies across the House are dealing with cases of children, relating in particular to CAMHS, who are on waiting lists for appointments to see psychologists, get access or get assessed. It is time for urgent intervention. That will necessitate using capacity other than public capacity.
Will the Taoiseach intervene to keep the 11 beds in Linn Dara open? I ask him to do so. Will the Government show urgency regarding the retention of staff and the recruitment of additional staff? I do not like saying this but the service is essentially not holding together. It is falling apart at the seams and there are problems.
Comment on this
I thank the Deputy. I do not accept that it is falling apart at the seams. I had a meeting with Deputy Browne and the Minister of State, Deputy McEntee, just last week where we discussed all of this. Funding for mental health, as Deputy Martin knows, has gone up from €826 million last year to €853 million this year, 2017. Over 160 additional posts have been recruited for the HSE mental health area over January to March this year. Recruitment campaigns are carried out to fill further vacancies and they are under way. Sanction has been given and money provided to recruit 114 assistant psychologists to enhance the early intervention primary care counselling services for under 18s in particular and to relieve pressure on the specialist CAMH service. The development of a plan for a 7/7 mental health care improvement nationally has been progressed and is nearing completion. It has prioritised that all areas provide access to a weekend service for current service users and not have situations where nobody has access to a service if he or she needs it. A full mapping exercise is being carried out countrywide. The HSE, at present, is consulting with all of the personnel in the health sector area and assessing the resource implications to develop costed actions. In addition, of course, the construction of the new 120-bed hospital to replace the Central Mental Hospital in Dundrum after over a century, along with a new ten-bed forensic CAMHS unit and a new ten-bed mental health intellectual disability unit, has been advanced. The Minister expects to sign that contract very shortly. Award of the construction contract is due to happen quite quickly. It has been recently agreed that in addition, the contract will also include a new 30-bed intensive care rehabilitation unit.
These are all positive signs of progress in an area that was neglected for so many years and was, over 30 years, the Cinderella of many Health Service Executive Votes and Department of Health Votes. When former Deputy Dan Neville was in opposition on that side of the House, he raised this matter consistently. I am glad that the Minister of State, Deputy McEntee, is making valiant efforts to deal with this.
Funding for this area includes youth mental health, improvement of the CAMHS and the adult services, services for older people, out-of-hours services, enhanced service user and carer engagement, perinatal mental health, attention deficit hyperactivity disorder, ADHD, in adults and children, dual diagnosis of those with mental health and substance abuse issues, increased services to meet the needs of those with severe and enduring mental illness with complex presentations and improved specialist clinical responses through clinical programmes.
Deputy Martin raised a specific case in respect of 11 beds. I do not have the details of that here, but I will undertake to follow up on that for him. I know it is an issue of concern locally, and Deputy Browne might have referred to that. Believe me, the Minister of State, Deputy McEntee, is working very hard in this area. The improvements I have outlined are long overdue and it is hoped they will make a significant improvement for the health, in particular the mental health, of children and young adults.
Comment on this
I am surprised the Taoiseach is not aware of the Linn Dara situation because it is all over the media. Linn Dara was opened in 2015 with fanfare. It has 22 beds, 11 of which are to close on Friday, and the children are going to be sent home.
Comment on this
They voted against it. We asked for €37.5 million in funding and they voted against it.
Comment on this
Will the Deputy please keep quiet? Where are those children going to go? That is the question I asked the Taoiseach. No one has an answer. These are children who were admitted in an emergency and they are at high risk. Every Deputy knows this. I have a list of CAMHS cases in my office and I have no doubt other Deputies do also. These are children in severe need of assessment, intervention, treatment and admission but it is simply not happening for them. The anxiety, stress and strain on the parents is unbelievable and unacceptable. It is inhumane.
Comment on this
What I asked the Taoiseach earlier is whether the Government will intervene to prevent the closure of the 11 beds in Linn Dara. It is next Friday we are talking about and nobody has come up with any alternative for the parents concerned other than those parents taking their children back home, which is not a solution.
Comment on this
We proposed 24-7 intervention services and they voted against that too.
Comment on this
Sending them to an adult facility is not a solution either. Surely it is within the remit and capacity of the Health Service Executive and the Department of Health to intervene to make sure that service does not close on Friday.
Comment on this
I am suspicious as to whether it can magically reopen in September, as per the HSE's comments to the news media this morning. That does not quite add up.
Comment on this
Let me clear up a few things for Deputy Martin. First, intensive efforts are under way to maintain the services at Linn Dara CAMHS unit at Cherry Orchard, Ballyfermot. The Minister of State, Deputy McEntee, is in regular and very close contact with the HSE in regard to the particular difficulties of providing adequate staffing, and meetings are under way this very afternoon. Clearly, however, there are staffing difficulties at this facility. At present, the unit is reliant on providing cover through methods such as staff working additional hours, overtime and agency staff. However, the core issue facing Linn Dara at present relates specifically to staff recruitment difficulties for mental health professionals. I pointed out to the Deputy that 160 have been recruited from January to March this year and an additional 114 assistant psychologists have been approved and are now under recruitment.
Let me clear this up for Deputy Martin. The problem facing Linn Dara does not relate to funding availability or the restructuring of any of the CAMHS services.
Comment on this
Let me assure people that any discharges from Linn Dara are clinical decisions and are planned discharges. No individual will be discharged to close beds. Let us be clear about that. The HSE is actively engaged in a recruitment process for Linn Dara and is meeting this afternoon. It is exploring every option to ensure this excellent service remains fully operational.
Comment on this
As I said, there has been an increase in moneys and the number of staff this year. Further approval has been given and no child is being sent out of Linn Dara because of either funding difficulties-----
Comment on this
They are not planned. I can show the Taoiseach the email.