I welcome the opportunity to speak to and support the motion. A Vision for Change, published in 2006, is a template for a community-based progressive and modern mental health system. The policy emphasises provision of a mental health system based on community services and supports provided by community-based multi-disciplinary teams with a significantly reduced need for inpatient services. Ten years later, there is a crisis in our mental health services arising from and compounded by the abject failure to fund, resource, staff and implement the A Vision for Change policy. The Government failed in budget 2017 to address the resource issues needed for mental health services. In July of this year, the Department of Health stated that €35.4 million per year over the next five years was needed to implement A Vision for Change. Despite that, only €15 million was provided; a shortfall, therefore, of €20 million.
The mental health services in my own constituency of Tipperary are a good example of the malaise in which the services are at both a local and national level. Despite the best efforts of staff, the service is dysfunctional. In 2010, then Fianna Fáil Minister of State, John Moloney, decided to close the county’s inpatient services at St. Michael’s unit in Clonmel. His successor, then Labour Party Minister of State, Kathleen Lynch, implemented that closure, despite the opposition of service users, carers, doctors, nursing staff and the public generally. South Tipperary inpatients were sent to Kilkenny and north Tipperary inpatients were sent to Ennis. That was done in 2012. The Minister of State sold the closure on the basis of a promise, quid pro quo, of a Rolls-Royce community-based service.
Three years later, we have the worst of all worlds. We have no inpatient service, community services are under-staffed, under-resourced and under-funded, and community-based teams are struggling to provide a safe service. They are deficient of staff across all categories of nursing, medical and paramedic staff. We have no 24-7 service. The new crisis house promised has not materialised. Patients are assessed in wholly unsuitable, busy and overcrowded accident and emergency departments with no privacy or confidentiality. The inpatient services in Kilkenny and Ennis are regularly overcrowded, there is difficulty in gaining admission and very often inappropriate early discharge. There is the proposed closure of the unit at Mount Sion in Tipperary town. The situation is wholly unacceptable. I call on the Minister of State to immediately implement A Vision for Change in Tipperary, including the provision of 24-7 services, the recruiting of additional nursing, medical and paramedic staff for our multi-disciplinary teams, the re-opening of the inpatient unit at St. Michael’s in Clonmel and a commitment to keep the Mount Sion unit open.
I acknowledge the excellent work being done by various voluntary organisations in the area of mental health locally.
I acknowledge organisations such as the consumer mental health panels, C-SAW suicide awareness group, the River Suir Suicide Patrol, Taxi Watch, the Wellness Recovery Action Plan support group and the Carrick-on-Suir River Rescue organisation among many others. I call on the Minister of State, Deputy McEntee, as a matter of urgency, to meet with a deputation from County Tipperary about the mental health services in the county.
I appeal to the Minister of State and the HSE to continue the funding of the five steps to living well with dementia project in south Tipperary. In 2012, south Tipperary received funding to develop a new and innovative dementia project for a three-year period. The project was jointly funded by Atlantic Philanthropies and the HSE through the Genio trust. It is time to put the funding for the project and services on a permanent basis. A core principle of the project and the services in south Tipperary is to provide flexible, person-centred care in the home and allow people to remain at home for as long as possible. The project has been a great success. It has already transformed the life experience of many people with dementia and their families in south Tipperary and is an ideal template for the national dementia strategy. Crucially, the development of the services included dementia sufferers, their carers, the Alzheimer Society of Ireland, the Carers Association, Muintir na Tíre, the South Tipperary Community and Voluntary Forum, GPs and representatives of the HSE. I acknowledge the vital input of people such as Dr. Caitríona Crowe, consultant in the psychiatry of old age, and Professor Eamon O’Shea of NUI Galway.
It is a five step programme, the key elements of which include a media campaign. The campaign was to raise awareness among the public about dementia, dispel myths and reduce stigma. There was buy-in to the programme by all the local media such as local radio stations, including Tipp FM, Tipp Mid West Radio and the print media. A community connector was appointed to liaise with organisations across the county and raise awareness in general about dementia and in particular about the services and supports available. Volunteers were largely provided by the Carers Association.
The single most important element of the programme was establishing a single point of contact to ensure people could access the information, supports and services they needed. The appointment of dementia support workers was also important. These people support people with dementia in their homes and ensure they can live at home for as long as possible and delay the need for long-term care. A further development at South Tipperary General Hospital is the memory technology library which provides a large range of assistive technology products to support people with memory loss. The programme in south Tipperary has been significant and successful and I compliment all those involved. I again ask the Minister of State to put permanent funding in place to continue it.
Speaking in the Dáil regarding Mental Health Services
I welcome the opportunity to speak on this motion and to indicate my support for it. A Vision for Change, launched in 2006, was a template for a community-based, progressive and modern mental health care system. Today, ten years later, there is a crisis in our mental health services arising from, and compounded by, the failure to implement the policy set out in A Vision for Change.
The mental health services in my constituency of Tipperary are a case in point and highlight the malaise in the service currently, both locally and nationally. Despite the best efforts of staff, the service is dysfunctional. The Minister of State’s predecessor, the former Labour Party Minister of State, Kathleen Lynch, closed the inpatient unit at South Tipperary General Hospital, St. Michael’s unit, and transferred south Tipperary patients to Kilkenny and north Tipperary patients to Ennis. That was in 2012. She sold that closure on the basis of a promised quid pro quo that we would have a Rolls-Royce community-based service.
Three years later we have the worst of all worlds. We have no inpatient service, a issue to which I will return, and our community services are understaffed, under-resourced and underfunded. Our community-based teams, multidisciplinary teams supposedly, are struggling to provide a safe service. They are deficient in terms of staff numbers across all categories – nursing, medical and paramedical staff members. The promised provision of a crisis house has not materialised. The inpatient service has been transferred to Kilkenny for people from south Tipperary and to Ennis for people from north Tipperary. That means assessments of patients have to take place in a busy overcrowded accident and emergency department with no privacy or confidentiality. The unit in Kilkenny is overcrowded regularly, there is difficulty gaining admission, and if one gains admission, there is the practice of early discharge. The situation is completely unacceptable.
I call on the Minister of State to implement A Vision for Change immediately, including the 24/7 services, to recruit additional nursing, medical and paramedical staff for the multidisciplinary teams and to reopen St. Michael’s unit in Tipperary. I acknowledge the work done by the various voluntary organisations in this area, the community consumer mental health panels, the C-Saw suicide awareness group and others, and thank them for it.
As part of the See Change – Green Ribbon Campaign running for the month of May, this event has been organised. The aim of the campaign is to get people talking about Mental Health and stop the Stigma associated with it. Everyone is welcome to attend, admission is free.
Despite the weather, there was a huge turnout in support of Mental Health Reform outside Leinster House this afternoon. It was a very emotional and powerful demonstration. More investment in our services is vital and these cuts must be reversed. #iscuisme #IAmAReason
Seamus Healy TD – 0872802199