I wish to raise mental health services in Tipperary again. My constituency colleagues and I have raised this matter on a number of occasions since the closure of St. Michael's acute psychiatric unit in Clonmel. There are now no inpatient psychiatric beds in north or south Tipperary. Patients in north Tipperary, which was in the old Mid-Western Health Board area, must attend the unit in Ennis while those in south Tipperary, which was in the old South Eastern Health Board area, have to attend the unit in Kilkenny. Both units are overcrowded and substandard and are simply not providing a service for patients from Tipperary. Admissions to the units are being delayed and when patients from Tipperary are admitted they are discharged, inappropriately I believe, ahead of time. There is no consistent follow-up of the patients and it is difficult, if not impossible, for their relatives and friends to support these patients in Kilkenny or Ennis. It is difficult to travel to support family members. Families have been contacting me and other representatives about this issue for some time.

Inpatient psychiatric beds must be provided in Tipperary. We need a seamless service not just in one area but across all areas. There must be a community-based service along with inpatient services. Patients in Tipperary are entitled to a quality service. There has been a significant increase in the number of suicides in the county since the closure of these beds and a number of organisations are demanding that they be reopened. Tipperary's Fight for Mental Health Services has organised many meetings and protests and the Save Our Acute Hospital Services Committee has been in discussions about this with the Minister and the HSE in the south east. It is time a decision is made at the highest level to reopen the beds that were wrongly closed in Clonmel in 2012.

I acknowledge Deputy Healy's ongoing interest in and commitment to health services in the south east. He has raised overcrowding in the hospital in Clonmel on many occasions, and we are making good progress on that, as well as on the mental health services. The move in mental health over the past couple of decades, in line with A Vision for Change which every party has signed up to, is to move away from the residential and institutional model of providing mental health and psychiatric care towards one that is based in the community. Twenty and 30 years ago huge numbers of people were treated in psychiatric hospitals. Over the intervening years we have tried to do two things - to get rid of psychiatric hospitals and move those people into mainstream health care, because mental health is mainstream health care and should never have been treated as something separate, and to reduce the number of people receiving the mental health services they need in a residential setting and move them to a community setting. Most people who have mental health problems do not need to be in hospital. They need treatment and they can get that in the community and stay in their homes. That has been the direction of travel and, broadly, it has been the correct one.

However, on occasion people need to be admitted so we need a certain number of inpatient hospital beds. I am advised that in the south east there is planning permission for, and construction is beginning on, a crisis house for the region. There is a particular focus on Tipperary when it comes to the distribution of advanced nurse practitioners and assistant psychologists - people working in the community who are qualified and can give people the support they need. The Minister of State, Deputy Jim Daly, has visited the area and met with the local representatives. He is giving consideration to the inclusion of inpatient beds in new builds that are proposed for the south east.

I acknowledge the commitment and involvement of the Minister of State on this issue. He has met deputations on a number of occasions and has visited Clonmel to see the services. We have always acknowledged the policy in A Vision for Change which would transfer the majority of services on a priority basis to community services. We have never had an issue with that and have always supported it fully, but there has to be a complete and seamless service. That involves both the community and inpatient beds. We met members of HSE management again recently and they acknowledged that there are at least 20 fewer beds in the area than there should be and that Tipperary would have a priority case for those beds.

A decision needs to be made at ministerial level to reverse the wrong decision to close beds at St. Michael's unit and, instead, to put in place a small number of beds immediately.

I again thank Deputy Healy for raising this important issue. I assure him that we will examine the matter that he suggests. Project Ireland 2040 provides over €10 billion for investment in our health infrastructure, including, buildings, equipment and ICT. As part of this spend, an additional 2,500 inpatient beds will be provided. As part of this expansion and the provision of those additional 2,500 beds, perhaps an appropriate number could be provided for mental health services in the south east. Where new beds are being provided, the intention is to open mental health and psychiatric wards in existing hospitals rather than reopen old psychiatric hospitals, thus mainstreaming mental health, as it always should have been. Centuries ago Descartes or somebody else suggested that somehow mental health was separate from physical health but we all know, although it may have taken us decades and centuries to relearn it, that mental health is intertwined with physical health and it is right that they be integrated again.