Working in the Community, Working for the Community

Tipperary Mental Health Services Keeping the Government Under Pressure

 

Earlier today Deputy Seamus Healy TD raised again in the Dáil at Leaders Questions with the Taoiseach the issue of the lack of adult inpatient psychiatric beds and the need for the provision of a properly resourced, properly funded and integrated mental health service in Tipperary with the Minister, He will as always keep you updated.

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“Healy Challenges Minister on Savage Council House Rent Increases”

“Support the Palestinian People”

This Saturday in Clonmel a petition will be taken up at the Main Guard in support of the people of Palestine.

I recently spoke in the Dáil of my support of the Palestinian people following the most recent atrocities there and asked that Ireland expel the Israeli ambassador and his staff and recall the Irish ambassador from Tel Aviv. Ireland must end the bilateral arms trade with Israel. It should call for an international military embargo on the state of Israel on the basis that it is murdering vast numbers of Palestinians in cold blood. Ireland must call for the suspension of the EU-Israel association agreement on the basis that Israel is in clear breach of the human rights clause in the agreement. Furthermore, the 11-year siege of Gaza must be lifted. We must commence an extensive boycott of Israeli goods and services. In 2014 both Houses of the Oireachtas unanimously called for the formal recognition of the state of Palestine. The Government must formally recognise it immediately.

In addition the Occupied Territories Bill 2018 introduced by Senator Frances Black is in Seanad Éireann on 11 July 2018, a Bill I fully support. It is Ireland’s time to take the lead and stand up for justice in Palestine and end trade in illegal settlement goods.

Statement in full:
Seamy Healy TD:
I condemn in the strongest possible terms the latest massacre of unarmed Palestinians by Israeli occupation forces. Last Monday, 14 May, was the single deadliest day for Palestinians in the occupied territories in over four years. The Great March of Return protests took place on the 70th anniversary of the Nakba, the expulsion – perhaps it might be better explained as ethnic cleansing – of over 750,000 Palestinians, or two thirds of the indigenous Arab population, from their homes by Israeli forces between 1947 and 1949. On Monday 60 unarmed Palestinians were shot dead and over 2,000 wounded. In the previous six weeks another 45 unarmed Palestinians were shot dead by Israeli state forces. The slaughter of unarmed Palestinian protesters carried out by Israel on Monday as part of its response to the Great March of Return in the past six weeks was cold blooded murder. As we all know, it was the very same as the shoot to kill policy implemented by British state forces in the Six Counties in previous years. The conduct of the Israeli state forces can rightly be compared to the outrageous and despicable campaign of murder and mayhem visited on this country by the infamous Black and Tans.

In the face of seven decades of consistent failure by the international community to enforce the inalienable rights of the Palestinian people, Palestinian civil society has taken it upon itself to assert its UN-mandated right of return. Unarmed protesters who are seeking to do this are being met with Israeli sniper bullets. Nothing has been done to punish Israel for the slaughter of over 100 unarmed Palestinians in the past two months. Instead, the United States has moved its embassy to Jerusalem and blocked UN Security Council resolutions condemning the killings, while the European Union has continued to reward Israel with increased co-operation. The entire situation is utterly shameful and sickening. The massacre of unarmed protesters while the world, including the European Union and the Government, stands idly by is utterly shameful. The protestors are simply demanding their rights under international law. They include the right to return, as set down in UN Resolution 194; the right not to be the subject of the collective punishment of an entire population, as is happening with the 11-year siege of Gaza; and the right not to have their lands illegally annexed for Israeli settlement expansions.

While it is all very fine for the Government to call in the Israeli ambassador, talk is cheap and action is needed. We need to expel the Israeli ambassador and his staff. We need to recall the Irish ambassador from Tel Aviv, just as South Africa has recalled its ambassador. Ireland must end the bilateral arms trade with Israel. It should call for an international military embargo on the state of Israel on the basis that it is murdering vast numbers of Palestinians in cold blood. Ireland must call for the suspension of the EU-Israel association agreement on the basis that Israel is in clear breach of the human rights clause in the agreement. Furthermore, the 11-year siege of Gaza must be lifted. We must commence an extensive boycott of Israeli goods and services. In 2014 both Houses of the Oireachtas unanimously called for the formal recognition of the state of Palestine. The Government must formally recognise it immediately. I commend all of the organisations, including the Ireland Palestine Solidarity Campaign, that are supporting the Palestinian people. I commend all of the people from Ireland who have visited the Palestinian territories in support of the cause. My own daughter has just returned from such a visit. She and her companions were blackguarded at the airport. They were held and interrogated for six hours. Some in the group were refused entry. It is time the international community, including the Government, stood up to Israel and supported the rights of the Palestinian people.

To ask the Minister for Health his plans to open adult inpatient psychiatric beds in County Tipperary; and if he will make a statement on the matter. [28609/18]

 

Priority Question 5. To ask the Minister for Health his plans to open adult inpatient psychiatric beds in County Tipperary; and if he will make a statement on the matter. [28609/18]

 

Séamus Healy (Tipperary, Workers and Unemployed Action Group)
This raises again the need for the provision of a properly resourced, properly funded and integrated mental health service for County Tipperary with particular reference to the need to reopen adult inpatient psychiatric beds wrongly closed at St. Michael’s unit in Clonmel in 2012.

 

Jim Daly (Cork South West, Fine Gael)  The provision of acute inpatient care to the adult population of north Tipperary, which is in CHO 3, is provided between the acute unit in University Hospital Limerick, which has 50 beds, and the acute psychiatric unit in Ennis, which has 39 beds.

The 44 bed department of psychiatry based at St Luke’s General Hospital, Kilkenny, is the designated approved centre for acute inpatient services for south Tipperary, which is in CHO 5. This enables all acute inpatient admissions for this CHO area to be managed at a single site. Referrals to St. Luke’s are through a consultant psychiatrist who makes the clinical decision to admit based on the level of acute presentation or need. In addition to the department of psychiatry, a dedicated psychiatric liaison team operates out of the emergency department in St. Luke’s. All service users presenting to the emergency department who require psychiatric assessment will receive that assessment within agreed timeframes in line with relevant guidelines. Onward referral pathways are agreed with all service users upon completion of psychiatric assessment in the emergency department. Pathways can include admission to an acute unit, referral to a relevant community mental health service team or referral back to a GP.

There are a range of other mental health services for adults in Tipperary. These include, for example, psychiatry of old age teams, non-acute beds, day hospitals and day centres. In addition, there are community mental health teams and high, medium and low-support community residences. In respect of those under 18, there are three CAMHS teams operating in Tipperary, one in north Tipperary and two in south Tipperary. The CAMHS acute units at Eist Linn in Cork and Merlin Park in Galway, which have a total of 42 beds, serve the Tipperary catchment area.

The HSE indicates that the south east community healthcare area has the second lowest rate of acute psychiatric bed provision. If this area were to be provided with the national average rate of bed provision, an additional 18 acute psychiatric care beds would be required. Evolving demographic pressures have recently led to over-occupancy at the departments of psychiatry at both St. Luke’s General Hospital Kilkenny and University Hospital Waterford.

The Deputy will be aware that I met local delegations on several occasions over recent months to discuss current and future provision of mental health services in Tipperary, including reviewing bed capacity. I also visited mental health facilities in south Tipperary in February last. Further to my correspondence of 11 May with the chief officer of CHO 5, the south east mental health service management team met a delegation of local representatives and discussed in detail all issues concerning the delivery of mental health services in Tipperary, including the potential for additional acute psychiatric beds across the south east community healthcare area. South east community healthcare mental health services has also engaged with HSE estates on the potential to develop psychiatric inpatient beds at the four acute hospital sites in the region.

I will continue to monitor the development of all mental health services in Tipperary, particularly in the context of progressing new service developments agreed under the HSE service plan and through additional investment for mental health provided by Government.

 

Séamus Healy (Tipperary, Workers and Unemployed Action Group)

I acknowledge the interest and involvement of the Minister of State in this issue since his appointment. As he said, he met representatives of the Save Our Acute Hospital Services Committee and Oireachtas Members on two occasions in Leinster House. He has visited the services in Clonmel and met all the stakeholders involved, including mental health service management in the south east. There is a serious and growing concern about the state of mental health services in the county, specifically that they are substandard and that there are no inpatient beds. A new umbrella organisation, Tipperary’s Fight for Mental Health Services, has been involved recently in public meetings and a public march on this issue. That organisation is supported by all the local Oireachtas Members and a large number of councillors as well. The Save Our Acute Hospital Services Committee has been engaging with mental health service management in the south east. At our most recent meeting, the management accepted that there was a shortage of beds in the south east and that Tipperary had a strong case for additional beds. They also indicated it would be helpful if the Minister of State was in a position to meet the negotiating team. Will he do that?

 

Jim Daly (Cork South West, Fine Gael)

The Deputy was present at the meeting with local Oireachtas representatives on 2 May and he has consistently been proactive on this issue. On 11 May, I wrote to the chief officer of CHO 5 outlining that there is a need to restore some acute bed provision for adults in Tipperary following the closure of St. Michael’s unit some years ago and given the consequent transport and access difficulties to St. Luke’s mental health unit in Kilkenny and to Ennis, which were highlighted to me. I emphasised the need for progress to construction as quickly as possible of the new respite crisis house in Clonmel to replace the existing facility there, including the provision of a construction date for that facility. I also highlighted the inadequate enhancement of community-based services since 2012 to compensate for the closure of St. Michael’s, particularly comparing the level of services envisaged by the HSE against what has been delivered, and referred to the inadequate staffing levels for both adult and CAMHS teams in Tipperary. I referred to the further issue of poor access to Eist Linn CAMHS unit in Cork, resulting in long stays for under-18s in adult health facilities in Tipperary, which has always been a concern of mine. The Deputy will be aware that I have spoken to a number of parents of children who have been left waiting in South Tipperary General Hospital, which is not appropriate or acceptable.

 

Séamus Healy (Tipperary, Workers and Unemployed Action Group)

The representatives of the Save Our Acute Hospital Services Committee have met mental health service management on three occasions. On the most recent occasion, they accepted that there is a need for additional beds in the area and that south Tipperary has a strong case. They also indicated that the Minister of State’s involvement at a future meeting would be helpful and I ask again if he would be prepared to do that. At this stage, we need action and political input at the highest level to move this issue forward.

 

I would be more than happy to continue the engagement I have had with the Deputy. I am concerned about the issues in south Tipperary and have a good understanding of them. I am awaiting a response from the chief officer of CHO 5. I asked my officials this week to follow up to ensure that I get a written response, which I expect to have in the next week or ten days. As soon as I have it, I will certainly be happy to engage further with the Deputy. There is potential in the development of the new 50-bed unit. I have asked HSE estates section to consider the provision of a number of those beds for mental health services without distorting the plans that are in progress. It should not create a delay. That is the route I am following and I will certainly meet with the Deputy, Oireachtas colleagues and whomever they want me to meet in Tipperary. My focus on working with the HSE and as soon as I receive a response from the chief officer, I will progress the issue.

Leaders Questions 26 June 2018

 

Séamus Healy (Tipperary, Workers and Unemployed Action Group)     Since Operation Pontus in the Mediterranean became Operation Sophia, the number of refugees landing in Italy has more than halved. For a considerable time, there has been serious concern that the price that the EU and Ireland are prepared to pay for stemming migration is the gross abuse of the human rights of migrants. The Irish office of Amnesty International has stated, “The Libyan coastguard is intercepting people in distress at sea and transferring them to Libya, where they are being held in detention centres and exposed to systematic and widespread human rights violations such as arbitrary detention, torture, rape and exploitation.” The statement goes on to indicate that while Ireland is not directly sending people back to Libya, it shares responsibility due to Europe’s joint actions to strengthen the capacity of the Libyan coastguard to intercept people and return them to Libya. Amnesty International has said that EU member states, including Ireland, cannot plausibly claim to be unaware of the grave violations being committed by some of the detention centre officials and coastguard agents with whom they co-operate. It has also argued that European Governments, including Ireland, stand accused of being knowingly complicit in the torture and exploitation of thousands of migrants and refugees by the EU-financed Libyan coastguard and officials running the country’s detention camps. The UN human rights chief, Prince Zeid Ra’ad Al Hussein, has also described the suffering of migrants in these camps as “an outrage to the conscience of humanity”. Médecins sans Frontières has also supported, in various reports, the views of those other organisations.

In view of the human rights abuses in Libya I have outlined, will the Taoiseach order Irish vessels to cease all co-operation with the Libyan coastguard? Will his Government cease participation in the training and funding of the Libyan coastguard through Operation Sophia? In a reply to a recent parliamentary question, I was told that, on its tour of duty, the LÉ Niamhrescued more than 600 migrants, 294 of whom were put ashore in Italy. Will the Taoiseach tell the Dáil to what non-Irish vessels were the remaining more than 300 migrants transferred? Where were those transferred migrants put ashore in each case? Will the Taoiseach give an assurance that none of these migrants was transferred to the Libyan coastguard by the LÉ Niamhor to any other vessel to which they had already been transferred?

 

Leo Varadkar (Taoiseach, Department of An Taoiseach; Dublin West, Fine Gael)    The Deputy asked if we will withdraw from our mission in the Mediterranean in Operation Sophia. We will not do so. I am very proud of the work that our Naval Service and Defence Forces are doing in the Mediterranean, rescuing migrants from the sea and training the Libyan coastguard to do what a coastguard should be able to do, namely, secure its seas and do its work, at least in its own territorial waters. It is an operation of which we are part. We are very proud of our Naval Service for being part of it. That will continue. The Deputy asked if people were transferred to the Libyan coastguard. I am advised by the Minister of State with responsibility for defence that this was not the case and people transferred to other boats were brought to Italy. I will seek confirmation of that to ensure I am correct in that regard.

It is evident to everyone in Europe that we face a large amount of migration from the Middle East and Africa. The numbers have decreased very considerably in the past couple of years.

Anyway, it has had a huge effect. It has had a big effect on the politics of Europe. We see that from the elections in Italy, where a populist anti-immigrant government has been elected and in the countries of central and eastern Europe, where anti-migration governments have been elected. We cannot be in denial about the fact that this has changed politics. Public opinion in Europe is changing too. We see it evident in Germany, which was initially welcoming to millions of migrants. Now, public opinion is in a very different place in Germany and we cannot be blind to the realities of that.

John McGuinness (Carlow-Kilkenny, Fianna Fail)    It is happening in Austria as well.

 

When it comes to co-operation with source countries and transit countries, we have to bear in mind why people risk their lives to travel to Europe and to cross the seas in the way they do. It is because they come from countries that are badly governed or unsafe or where there is no economic opportunity. That is why it must be part of the core mission of Europe, when it comes to the Middle East and Africa, to try to build peace and security and bring about economic opportunities in the Middle East and Africa. We have seen how the power of the free market in Asia has lifted 1 billion people out of poverty in 20 years. We need to see that kind of power happen in Africa as well so that people are not forced to travel.

We need to step up border security as well because what is happening is terrible. People are travelling huge distances. Traffickers put them in dinghies and boats that are not seaworthy knowing full well that European navies and others will come to the rescue and bring them the rest of the journey. That is something that cannot be encouraged. None of us should in any way encourage human trafficking of that nature. The Libyan coastguard has a big job to do to deal with that.

 

I note he failed to give an assurance that Ireland will stop training and funding the Libyan coastguard and, through the coastguard, the Libyan Government, which is torturing migrants in these camps.

The Taoiseach is Minister for Defence and, as such, he is responsible for this area of operations. In a parliamentary reply recently I was told that 139 suspected people smugglers or traffickers had been apprehended under Operation Sophia and that 545 boats were taken from criminal organisations. Were any of these boats or smugglers handed back to the Libyan coastguard? More important, were any of the refugees or migrants on these boats handed over to the Libyan coastguard or any other Libyan ships to be sent back to detention centres in Libya?

 

I will double check so that I am sure, but I am informed that none of them was handed over to the Libyan coastguard and that they were taken to European countries.

The Deputy ascribed comments to those various organisations. I am not sure that they said that about the Government. One or two might have but they certainly did not all say that. It is very much our position as a government that the camps or detention centres should be run by the United Nations High Commissioner for Refugees, UNHCR, or the International Organization for Migration, IOM.

 

The UNHCR said it.

 

That is very much the point I will make at the summit of European prime ministers later this week. Reception centres, where they exist, should be run by the UNHCR or the IOM so that we can be assured human rights are upheld and standards are protected. At the same time, we need to ensure we never equivocate on human trafficking. No one should do anything to facilitate these people smugglers and human traffickers.

I am afraid that some actors in this area are doing that. It might not be their intention but they are doing it.

 

 

Press Statement on Mental Health

 

Healy says people being failed by our Mental Health
System and calls for a big turn-out at Thursday’s
meeting in Clonmel’s Park Hotel.

During Leader’s Questions on Thursday 26 th of April
Deputy Healy said:

“Children with Mental Health difficulties and their
parents face immense challenges to get an adequate,
or indeed any, service. Due to this, many children carry
those difficulties into their adult lives.
The position would be much worse were it not for the
tremendous work done by community and voluntary
organisations across the country. There are many such
organisations in my own area, including the River Suir
Suicide Patrol, Taxi Watch and C-SAW, the community
suicide awareness workers. These all operate on a
voluntary, unpaid basis and do tremendous work.
There is huge frustration among these organisations,
which feel alone in dealing with issues that should be
properly dealt with by the public mental health service.
These organisations need to be acknowledged,
supported and resourced, along with financial support.

Press Statement on Mental Health

We are failing to provide for our young people. We
need to do so urgently, it must become a Government
priority. We cannot, should not, and hopefully, will not
kick the can further down the road in this. They need
to be implemented urgently not in the next budget but
now, because this is something that is affecting young
people on a minute by minute basis.

Children and young people are being failed by our
mental health system. For the past three months since
February, young people experiencing mental health
difficulties have been admitted to the paediatric ward
in South Tipperary General Hospital. Today, there are
three young people on the ward. There have been as
many as five and their lengths of stay have been as
long as eight weeks. The reason for this, as we all
know, is that there are simply not enough inpatient
beds for young people with mental health difficulties.

Admissions to the paediatric ward in South Tipperary
General Hospital are totally inappropriate.

Nursing staff do their best. They are kind,
compassionate and caring but they are not trained to

Press Statement on Mental Health

provide mental health care. Parents, usually mothers,
must stay on the ward overnight to give support to
their children. Of course, there are knock-on effects in
delayed admissions for other patients.
Every day, young people with mental health difficulties
do not receive the age-appropriate timely services and
supports they need. This causes psychological and
social damage to these young people. It has a
detrimental effect, not just on themselves, but also on
their parents, their siblings, their schools and their
communities. Of course, it reinforces the whole stigma
regarding those with mental health difficulties.

We all know what needs to be done. We have had
report after report. The problem is we have had no
action on those reports or their recommendations.
I remind the Tánaiste that to tackle this significant
issue, we need:
1. additional inpatient beds for children and young
people with mental health difficulties
2. 24-7 crisis intervention teams providing rapid
assessment for those children and young people
3. a comprehensive primary care counselling service
4. a fully staffed existing child and adolescent mental
health teams

Press Statement on Mental Health
5. to resource and support, including financially,
community and voluntary organisations working in
these areas
6. a designated leader – a tsar-type arrangement –
whose sole duty and responsibility will be to drive
the implementation of these measures to ensure
our young people get the services they deserve
and need urgently. It should be like how cancer
care services developed recently

When will we see these measures being implemented
by the Government?

***END***

Link to full Dáil Speech in Leader’s Questions and An
Tánaiste’s Response:
http://oireachtasdebates.oireachtas.ie/debates%20aut
horing/debateswebpack.nsf/takes/dail2018042600015
?opendocument

Seamus Healy T.D.
087 2802199

Leaders Questions 26 April 2018

Today in the Dáil I raised during Leaders Questions the serious issue of our children and young people being failed by our mental health system.
Children and their parents face immense challenges to get an adequate, or indeed any, service. Due to this, many children carry those difficulties into their adult lives.
 
The position would be much worse were it not for the tremendous work done by community and voluntary organisations across the country. There are many such organisations in my own area, including the River Suir Suicide Patrol, Taxi Watch and C-SAW, the community suicide awareness workers. These all operate on a voluntary, unpaid basis and do tremendous work. There is huge frustration among these organisations, which feel alone in dealing with issues that should be properly dealt with by the public mental health service. These organisations need to be acknowledged, supported and resourced, along with financial support.
 
We are failing to provide for our young people. We need to do so urgently, it must become a Government priority. We cannot, should not, and hopefully, will not kick the can further down the road in this. They need to be implemented urgently not in the next budget but now, because this is something that is affecting young people on a minute by minute basis.
Leaders Questions 26 April 2018
Deputy Seamus Healy: Children and young people are being failed by our mental health system. For the past three months since February, young people experiencing mental health difficulties have been admitted to the paediatric ward in South Tipperary General Hospital. Today, there are three young people on the ward. There have been as many as five and their lengths of stay have been as long as eight weeks. The reason for this, as we all know, is that there are simply not enough inpatient beds for young people with mental health difficulties.
 
Admissions to the paediatric ward in South Tipperary General Hospital are totally inappropriate. Nursing staff do their best. They are kind, compassionate and caring but they are not trained to provide mental health care. Parents, usually mothers, must stay on the ward overnight to give support to their children. Of course, there are knock-on effects in delayed admissions for other patients. Every day, young people with mental health difficulties do not receive the age-appropriate timely services and supports they need. This causes psychological and social damage to these young people. It has a detrimental effect, not just on themselves, but also on their parents, their siblings, their schools and their communities. Of course, it reinforces the whole stigma regarding those with mental health difficulties. Children and their parents face immense challenges to get an adequate, or indeed any, service. Due to this, many children carry those difficulties into their adult lives.
 
We all know what needs to be done. We have had report after report. The problem is we have had no action on those reports or their recommendations. I remind the Tánaiste that to tackle this significant issue, we need additional inpatient beds for children and young people with mental health difficulties and 24-7 crisis intervention teams providing rapid assessment for those children and young people. We need a comprehensive primary care counselling service and a fully staffed existing child and adolescent mental health teams. We also need to resource and support, including financially, community and voluntary organisations working in these areas. We need a designated leader – a tsar-type arrangement – whose sole duty and responsibility will be to drive the implementation of these measures to ensure our young people get the services they deserve and need urgently. It should be like how cancer care services developed recently.
 
When will we see these measures being implemented by the Government?
 
The Tánaiste: I will ask the Minister of State, Deputy Jim Daly, to revert to the Deputy with more details on South Tipperary General Hospital after Leaders’ Questions. He is aware of some of the cases to which the Deputy referred and he has spoken to some of the parents involved.
 
Staffing and necessary skills shortages need to be addressed in the context of extra beds. Up to €55 million of additional funding has been committed for next year to develop new services, which will involve ten new beds in the Central Mental Hospital and 20 new child and adolescent mental health services, CAMHS, beds coming to the new children’s hospital. There is a recognition that there is a deficit. We are providing significant resources to address that.
 
On the broader mental health service issues, funding this year is almost €1 billion at €910 million. That is an increase of €200 million since 2012. In excess of 2,000 new posts have been approved since 2012, of which over 1,300, 66%, have been recruited with recruitment ongoing for the remainder. The appointment of 114 assistant psychologists and 20 staff grade psychologists for primary care child psychology services is ongoing. A series of actions are happening which are linked to reports which have been done. This represents incremental improvement all the time.
 
However, I am aware there are certain pressure points in different parts of the country. This is a particularly sensitive area in child and adolescent mental health services. We have seen significant increases in funding and funding commitments with the staff and beds that need to go with that. The challenge is ongoing. I will ask the Minister of State, Deputy Jim Daly, to come back to the Deputy with a more detailed answer on services in Tipperary.
 
Deputy Seamus Healy: While I thank the Tánaiste for the reply, we cannot continue to kick this can down the road. These issues must be dealt with urgently. The Tánaiste referred to recruitment. There are currently 500 psychiatric nurse vacancies in this country. The position would be much worse were it not for the tremendous work done by community and voluntary organisations across the country. There are many such organisations in my own area, including the River Suir Suicide Patrol, Taxi Watch and C-SAW, the community suicide awareness workers. These all operate on a voluntary, unpaid basis and do tremendous work. There is huge frustration among these organisations, which feel alone in dealing with issues that should be properly dealt with by the public mental health service. These organisations need to be acknowledged, supported and resourced, along with financial support.
 
We are failing to provide for our young people. We need to do so urgently, it must become a Government priority. We cannot, should not, and hopefully, will not kick the can further down the road in this. They need to be implemented urgently not in the next budget but now, because this is something that is affecting young people on a minute by minute basis.
 
 
The Tánaiste: I reaffirm to the Deputy that no one is kicking the can down the road on anything here. It is a programme of action that is already under way. The construction of a national forensic mental health complex at Portrane is progressing well and should be completed by 2020. There are other improvements such as in counselling services, including new Jigsaw sites in Cork, Dublin and Limerick, to bring a total of 13 sites nationally, and there is continued development of the community mental health teams and improved 24-7 response and liaison services are improving the contact within communities. An eating disorder care programme was launched in January 2018, which is patient-centred in care and recovery. In line with the provisions of A Vision for Change, the HSE has prioritised mental health needs for those under 18 years. We are focusing on reducing CAMHS waiting lists and improving mental health teams. There are currently 69 CAMHS teams nationally. The Minister of State, Deputy Jim Daly, is working with the HSE and officials to establish a national telephone and text line for mental health services, and the list goes on. There are a lot of things happening in this area but there is a lot more to be done, and we recognise that.

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