I welcome the Minister of State, Deputy Mary Butler, to the House.

I thank the Minister of State for coming here today. I very much appreciate that the line Minister of State is here to answer my Commencement matter.

I am here to talk about the national service model for the mental health of intellectual disability. I might explain that. Tens of thousands of people throughout the Republic suffer from intellectual disabilities. Many of these people live at home with elderly parents. There are 55,000 disabled adults over the age of 25 living at home with parents who are over the age of 60. A plan for the mental health of intellectual disability service was published in 2021 to establish teams around the country to meet the needs of this very vulnerable community and their carers. Since then, however, only one team has been set up fully with the proper complement of nurses, a consultant psychiatrist with higher specialist training in the mental health of intellectual disability, social workers, psychologists, occupational therapists, OTs, and physiotherapists. There is only one team - a pilot project in Cavan. Throughout the rest of the country, those teams are not filled.

I have been approached by a number of hospital consultants and executive clinical directors in the field of mental health of intellectual disability. I have also spoken to the chair of the faculty of mental health of intellectual disability in the Irish College of Psychiatry. They confirm that these teams are not fully staffed and are not funded. The HSE has said that the reason for that is that they cannot recruit allied health professionals, such as psychologists, social workers, physiotherapists and so on but that is not the case. In fact, the HSE is refusing to fund these posts. That is not the fault of the Minister of State, but perhaps she could encourage it to do so. In Cork, for example, there is a team and all it has is a consultant and executive clinical director. It has no social worker, no psychologist and no occupational therapists.

That is the fact of the matter today. Given the huge client base of hundreds of older adults with intellectual disabilities who are also particularly prone to mental illness, and in the absence of all of those allied therapies, what consultants have to do - it causes them moral distress - is overprescribe psychotropic medicines, which have very heavy side effects. When one consultant was able to get some psychology support and some OT support, they were able to get one intellectually disabled adult out of a wheelchair and walking again. Another disabled adult has been able to be titrated from a heavy psychotropic medicine to the stage where she can now feed herself. Another disabled adult, having been de-prescribed because of access to these supports, has been able to take up full paid employment in the community. Here is one of the saddest examples: a family reports that an adult with an intellectual disability has recovered her personality and has a sense of humour again. When we think of those parents getting older and being terrified about what is going to happen to their children, the least we can do is fully fund and staff these mental health of intellectual disability teams throughout the State.

Before I call the Minister of State, I would like to welcome the teachers and students from Gaelscoil Riabhach atá anseo leis an Seanadóir Shane Curley.

I also issue a céad míle fáilte roimh páistí na Gaelscoile. They are very welcome here today with Senator Shane Curley.

I thank Senator Clonan for raising this important matter in the House. I also thank him for his constant advocacy for people with disabilities, including intellectual disabilities. Expanded access to specialist mental health services, including the national clinical programme for mental health intellectual disability, is a priority for me. It is estimated that four in every ten people with intellectual disabilities can experience a mental illness in their lifetimes. The HSE developed the national clinical programme for mental health intellectual disability to better support people with intellectual disabilities with their mental health. I launched that model of care in 2021 with the objective of improving mental health service experiences and outcomes for people with intellectual disabilities.

I stand here as the Minister of State who has had responsibility for mental health since 2020 and as a Minister of State for whom the glass is always half full as opposed to half empty. In 2020, there were 220 teams across Ireland for mental health. There are now 285. By any yardstick, funding of 65 additional teams has to be acknowledged.

There were services for mental health intellectual disability in place already but the process of developing teams began with the formation of several small teams around the country. Under the model of care, there should be 31 adult teams and 16 children’s teams nationally. It is a specialist adult mental health service, with clinicians who have the appropriate training and experience to assess and treat people with mental health intellectual disability, taking into account their specific needs. As per the model, teams should include psychiatrists, clinical nurse specialists, speech and language therapists, social workers and occupational therapists. All professionals on each team work with the individual and family or caregiver to develop holistic care plans that meet their wishes and needs and provide evidence-based interventions to achieve the best outcomes.

The mental health intellectual disability national clinical programme is being implemented through the development of multidisciplinary teams on a phased or incremental basis. There are now 30 teams of various sizes in place: 20 adult teams and ten child and adolescent mental health service, CAMHS, teams. Parallel to that, I have put in place clinical programmes for ADHD, with 11 teams funded across the country; eating disorders, with 14 teams funded across the country; dual diagnosis; early intervention in psychosis; and mental health with intellectual disabilities.

One of the decisions I took over the past two years was to look at the postcode lottery and, instead of putting a full team into one area, having starter teams in two different areas. I speak to clinicians, consultants and the college of psychiatry, and we all know that the most important part of that team is the consultant psychiatrist, with the admin supports. It is great to have the multidisciplinary approach and that is what I am trying to get to, but I have funded consultant psychiatrists in starter teams. I will get three consultant psychiatrists for €1 million. I will get a whole team for €1 million but I want to get the services into as many areas as possible. That is why we have 20 teams in place for adults and ten for children.

I am conscious of the challenges for children with intellectual disabilities and for adults living at home with intellectual disabilities. I funded 15 posts this year. I will fund, please God, more posts next year. I have to build the models of care not only across intellectual disabilities but across six or seven definitions at the same time. That is what I try to do. I try to do a little every year. Fifteen posts this year would have cost in excess of €2.5 million. It is recurring funding. It is not if and when; it is embedded in the base.

I thank the Minister of State for her response. There is nothing personal in what I am about to say. Over the past number of years, I have got to know her a little bit and she is a person of the highest integrity. She mentioned an increase from 220 to 285 funded teams throughout the State. At the same time, she says 30 teams of various sizes have been stood up. There is quite a discrepancy in those figures. Maybe that is something we can clarify subsequently. I might write to her about that.

For adults with intellectual disabilities who used to be held in congregated settings, their services have now been moved to the community but I can tell the Minister of State that those services are not available to them. I agree that there are some of what the Minister of State calls starter teams, but they are seriously understaffed. Those consultants tell me it is not a recruitment issue but a refusal on the part of the HSE in those regional areas to fund the posts and go about the business of recruiting the allied health professionals.

I have the HSE's back on this. I will tell the Senator why. In budget 2026, I was able to fund 300 new posts. The difference between the mental health budget and the rest of the budget is that funding for those 300 posts is ring-fenced. I wrote to the six regional executive officers across the six regions to say I had secured this funding under the mental health budget. Three hundred whole-time equivalents is quite a significant number; it is the most I have got in the six years.

There were 15 posts for intellectual disabilities. Their funding is ring-fenced and recurring, and they have to be recruited. I have monthly meetings with the HSE and the Department to make sure this happens. I break my back to get as much funding as I can. I have increased the budget for mental health by 60% in the past six years. It is difficult when it comes to recruitment but I have not had push-back from any of the regional executive officers when they are told they have this ring-fenced funding to recruit. They can do more under their own budgets and we have seen that in areas.

I am aware, especially in relation children with intellectual disabilities, that we are trying to smooth the pathway for children. Whether they belong in a CAMHS team, a children's disability network team, CDNT, primary care psychology or the National Educational Psychological Service, NEPS, they are being pushed from Billy to Jack. I accept that 100%. That is an area we have a strong focus on. All that parents want, whether for an adult child or a younger child who is dependent on them, is for them to get the services. I will do more in next year's budget and I will make sure that those 15 posts are recruited this year. I thank the Senator for his advocacy.