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Dáil Diary no. 32- 16th April 2015


Mental Health Challenges in Wexford – Government Action Urgently Needed…


Ignoring Wexford’s mental health issues will not make them go away – but this is exactly what the Government seems to be doing. Successive cuts to substance abuse rehabilitation centres, and the ongoing lack of a 24-hour acute mental health service in the county, mean that people who need help often have nowhere to turn. After promising in its Programme for Government to “protect the vulnerable,” sadly, this is not what is happening. The policies of austerity and the neoliberal agenda which is largely driven by the EU, are the cornerstone of what this coalition Government is about; and the most vulnerable in our society have suffered the most. With a suicide rate of twice the national average, Wexford urgently needs help. I had a parliamentary question on this topic yesterday with Minister for Health Leo Varadkar, and here is my Dáil contribution on the issue –

"I heard the Minister's earlier reply to Deputy Ó Caoláin. I accept the Minister is starting to make some progress in this area but there is much catch-up to do. The Minister is well aware that there is a strong link between substance abuse and mental illness. Without it sounding too much as if I am engaging in parish pump politics about this, Wexford has suffered more than most areas and things are particularly difficult there. Successive budgets have slashed up to 25% of provision in this area. We have no 24-hour acute mental health facility in the county. The Cornmarket project in Wexford, which provides a drug rehabilitation programme, has noted a yearly increase of 20% in the number of clients accessing its drug rehabilitation programme. There are particular problems and challenges there which the Minister might consider attending to.

Deputy Leo Varadkar: As the Deputy will be aware, the economic crisis necessitated significant reductions in health service expenditure in recent years. Notwithstanding the difficult economic climate, a range of new services have been introduced in the south east in the past five years, which have been of benefit to those in County Wexford who are affected by substance misuse issues. The additional services provided in Wexford include a new methadone maintenance treatment service and the expansion of needle exchange, with 12 pharmacies now offering this facility in the county. The HSE has also commissioned 12 new detox beds, including a four-bed adolescent detox service in Kilkenny, which can be accessed by people resident in the south east, including Wexford. More than €3.8 million has been provided for addiction services in the south east this year, in line with the Government's policy of focusing resources on services. This includes €1.06 million for the south-east regional drugs task force, the same level of funding as 2014. Reflecting the Government’s commitment to the national drugs strategy, we have also provided an additional €2.1 million in the HSE budget nationally for this year for measures to benefit vulnerable problem drug users. The resources available to address substance misuse will be kept under review in the context of the overall resources available to the health services and the most effective utilisation of those resources.

Deputy Mick Wallace: I was approached by a doctor two weeks ago at home and he pointed out that the lack of a 24-hour acute mental health service in the county is a dramatic problem in Wexford. He pointed out that since the merger of acute services for Waterford and Wexford, in Waterford in 2011, many of those in need of help in Wexford have been left with no access to these vital services. He claimed that a person going through a mental health episode needs a referral letter from a GP in order to get an appointment with a psychiatrist. If the person is at risk of self-harm, he or she would be referred to the accident and emergency department at Wexford General Hospital, which is not equipped to deal with psychiatric patients, where they could wait up to 24 hours before seeing a liaison nurse who would then speak to a psychiatrist. From there they could be referred to the accident and emergency department in Waterford where they could again have to spend hours in a queue. Apart from the obvious fact that people are not getting the care they need, and that the need for a person with a mental illness to be seen is often time-sensitive, the person often cannot even get a lift to Waterford. Many family members have contacted me and said that having this unit in Waterford is not quite good enough for the many people in Wexford who are in dire need.


Deputy Leo Varadkar: The question the Deputy asked related to cuts to funding to drugs and alcohol treatment in County Wexford. Had I been aware that he wanted to raise mental health services more broadly in the south east, I would have prepared for the question a bit better. I am informed that the 24-hour service for the south east operates from Waterford and that Wexford is catered for from there but also by its own community services across the county. Increasingly in the mental health area we are moving towards much stronger community services and centralised acute 24-hour services. That would have happened also, for example, in my part of Dublin where we had the old St. Brendan's Hospital but that has now changed very much to a community-based service with some acute services in Blanchardstown.

Deputy Mick Wallace: It would be less challenging to merge units in Dublin or whatever. If a person is in dire need of help and is living in Wexford town, it can be a massive problem for them to have to go to Waterford. I understand the Government does not have a limitless supply of money but Wexford hospital has the infrastructure to house a 24-hour acute unit. The facility to provide for it is there. I understand it will cost money to put such a unit in place. The problem in this area will continue and it will increase. It is hard to credit that Wexford has the second highest suicide rate in country. It has one of the highest illiteracy rates and one of the highest teenage pregnancy rates in the country. We have an unemployment rate of just under 24%. It is an abandoned county. There are some serious challenges in the county. There are more challenges in the mental health and drug abuse area, in Wexford, than there are in most areas. The Minister should examine the prospect of putting a 24-hour acute unit in place in Wexford General Hospital. I do not know what it would cost but it is something he should consider.

Deputy Leo Varadkar: As far as I understand, people can be seen in the community and from there be referred to the specialist centre in Waterford if that is what is best for them. It is worth pointing out, and I hope this will not be taken up wrong, that there are such things as psychiatric emergencies. Provision can be made, using either emergency ambulances or intermediate care vehicles to transfer patients to the right units in emergencies. That is done for all other types of illness and it can be, and is, done in mental health cases as well.

Mick Wallace.

 

 

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