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 Header Item Mental Health Services Provision (Continued)
 Header Item Community Care

Thursday, 23 March 2017

Dáil Éireann Debate
Vol. 944 No. 1

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(Speaker Continuing)

[Deputy Marcella Corcoran Kennedy: Information on Marcella Corcoran Kennedy Zoom on Marcella Corcoran Kennedy]  Wexford mental health services have advised that the CAMHS psychologist relocated in November 2016 but that a replacement psychologist has been appointed for CAMHS. This psychologist will start next week on 27 March. I know the Deputy will welcome this news. Upon commencement in the post, it is intended that the CAMHS psychology waiting list will be triaged and appointments will be offered based on prioritisation of clinical need. In addition, approval has been granted to recruit a staff grade psychologist post in CAMHS and the process for recruitment is under way.

Psychology services in Wexford are delivered through primary care and disability services across the catchment area of Wexford. Children or young people are usually referred to primary care psychology services for a number of behavioural or emotional concerns. It is more common for young people to raise suicidai ideation as a concern during their assessment or intervention rather than it being a reason for referral to primary care psychology unless a previous assessment has been completed, for example, by CAMHS.

When a young person discusses suicidal ideation within an assessment and-or intervention, he or she receives a thorough psychological assessment and intervention is offered to a high standard. In recent years a number of factors have impacted on waiting times in psychology services. These include population growth in the Wexford area, significantly increased service demands and more complex demands and, as referred to earlier, staffing challenges. As with many other areas throughout the country, there are staffing challenges within Wexford psychology services, including maternity leave, sick leave and reduced working hours, which are impacting on waiting times. Unfortunately, there is also an overall national shortage of psychologists at this time which has contributed to increasing waiting times both locally and nationally.

The HSE tells me that it continues to endeavour to address such issues that arise through a number of measures. These include continuing to actively fill approved posts, monitoring waiting lists in line with available resources and prioritisation criteria and reconfiguring children’s disability services into geographicaIly-based early-intervention and school-aged teams as part of the national progressing disability services for children and young people programme, which will ensure a more equitable delivery of services.

Deputy Mick Wallace: Information on Mick Wallace Zoom on Mick Wallace I thank the Minister of State for her response. I know this is not her responsibility but the truth of the matter is that not only are psychology services in Wexford poor and not only is the HSE's approach to the problems that prevail in Wexford very poor, but there is not near enough emphasis on psychology. I am not even sure if there is a psychotherapist on the books of the HSE. Perhaps there is, but I am do not know of it.

The girl I mentioned needs psychological help, psychotherapy or counselling. CAMHS have psychotherapists but not psychologists on their team. Publicly-funded psychotherapy and counselling is practically non-existent in Wexford. The girl and her mother met the HSE psychologist in Grogan's Road in Wexford in June 2016. The psychologist stated that the girl was a candidate for the service and that it could help her but that there is a waiting list. The Minister of State spoke about the waiting list problem. However, in February 2017 her mother asked for an update on child psychology services for the girl. She was told that the HSE psychologist the girl met in June 2016 had left and that there was now only one psychologist working with children in the county.

We were also contacted this month by the mother of a seven year old boy in Wexford. This boy has waited for a year and a half to access CAMHS and occupational therapy. The boy goes to his local school in Wexford but he does not attend the mainstream classes there as he has expressed a wish to kill himself in front of other students. He is seven years old. The boy was referred to the senior child psychologist in Wexford in March 2015. He has been waiting since then to see a child psychologist. He has now been waiting for more than two years. A seven year old child has expressed a desire to kill himself but he is yet to get the help he needs.

We have had one of the highest rates of suicide for a number of years. The last time I checked - a couple of weeks ago - we had 19% unemployment. We are not getting the help that we need and the HSE's approach leaves too much to be desired. Will we ever get a Government to address the dysfunctional nature of how the HSE operates? The mental health services available in Wexford today are pathetic and something has to change. Something has to give.

Deputy Marcella Corcoran Kennedy: Information on Marcella Corcoran Kennedy Zoom on Marcella Corcoran Kennedy I reiterate the good news, which is that a psychologist will start next week. This will certainly be an advantage. As I stated earlier, prioritisation of those on the waiting list will have to commence as soon as possible. I wish to provide some form of reassurance because I know the Deputy is frustrated at particular issues - we all are. It is heartbreaking to think that the child the Deputy referred to would be experiencing such thoughts at that age. The self-harm intervention programme that was established in Wexford in 2004 is a free and confidential service. Children under 16 years of age experiencing that are referred by a GP or another medical professional to the service.

Ferns Diocesan Youth Service, which is funded through the HSE and partly funded by Tusla, is doing additional work. It provides supports for young people who are referred into the HSE substance misuse services. We must recognise that those engaged in the misuse of alcohol and other psychoactive substances are more prone to suicidal ideation. Those in the LGBTI community are also impacted in this regard and, in particular, are at risk of self-harm. To try to be positive, that there was a new appointment should certainly try to get things back at the level we want them in Wexford.

Community Care

Deputy Pat Deering: Information on Patrick Deering Zoom on Patrick Deering I am delighted to have the opportunity to speak on this issue today. I have been trying to raise it for the past six or seven weeks. Eventually, my time has come.

To provide background to the situation, this concerns the Cheshire home group and, in particular, my local one in Tullow in County Carlow. Cheshire Ireland is a non-profit provider that is predominantly funded by the HSE. It currently provides support services in 17 different residential centres in addition to a range of community-based services throughout the country. It employs approximately 700 people.

A new policy on residential support for persons with disabilities has been agreed between the HSE and resident services providers. This policy is outlined in Time to Move on from Congregated Settings - A Strategy for Community Inclusion, which was published by the HSE in 2011. It aims to provide residents of congregated settings with alternative accommodation and care services in mainstream communities. In order to implement the policy, the Cheshire home group, as has other residential care service providers, has proposed to progressively close all their institutions that are serving ten or more people by not later than 2019. As the Minister of State knows, this process is currently under way and will result in compulsory redundancies of a number of catering and domestic staff.

The Cheshire home group has experienced financial difficulties in recent times and since 2008 has been in severe difficulty. In an effort to counteract these difficulties, it entered into an agreement with SIPTU, the INMO and Unite in 2014 under the Labour Relations Commission. As part of that agreement, the HSE was to fund a number of the outstanding issues of the Cheshire home group. This was supposed to happen by December 2015 at the very latest. As of today, it has not happened. Almost all the staff have been made redundant in my local Cheshire home which is almost closed as most of the service users have been moved out to the community-based services.

A commitment was given that no more staff would be made redundant until this issue was resolved. My understanding is that staff are to be made redundant in the next number of days and this issue still has not been resolved. What is the position regarding the commitment made as part of the Labour Relations Commission agreement?


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