Mary Butler
Waterford · Fianna Fáil · Ireland
“Major improvements are happening across services: enhanced access to proactive and preventive healthcare to support a better quality of life; the embedding and upscaling of women's health initiatives put in place through the implementation of the previous women's health action plans, including, as the Senator knows, free contraception, sp…”
“In relation to any proposal, a proposal for a new location requires a detailed business case, a premises, support from the regional HSE management, and the necessary funding to resource the staffing of the service. That is where I come into it and what I will be trying to do.”
“We are currently working closely with it to support the expansion of Jigsaw services to Waterford and the south east, as well as to County Clare. The location of Waterford was picked because we have no services in the south east at all. It is great that we will have the hub and spoke model the Senator spoke about.”
“That is where I do not agree with the Senator. I believe €180 million of funding ring-fenced for women's health, when we have come from a low base, is absolutely unbelievable.”
“The plan will build on our knowledge of women's health through research and innovation and will spotlight important areas such as endometriosis and cardiovascular health. Recently, the Minister announced €2 million in funding for women's health research.”
“This plan will continue to focus on how we can improve access to specialist endometriosis care and treatment. As the Senator knows, we have established two super-regional specialist centres, one in Tallaght University Hospital and another in Cork, alongside the development of five regional endometriosis hubs.”
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“The Deputy raised a valid point. The priority over the past few years has been community supports because 90% of people with an eating disorder are treated in the community. It is a very difficult mental health disorder and for many people it takes over their entire life. It can sometimes take up to seven years for recovery and some people relapse. It is very challenging, and I am happy to see the roll-out of the supports. The demand is still very high, and we will continue to do that. In relation to young people under 18 years old with an eating disorder, we have 22 dedicated beds in Cherry Orchard, Dublin, Merlin Park, Galway and Eist Linn, County Cork. The story is not a good when it comes to adults. This is my next focus. We currently have three dedicated beds in St. Vincent's Hospital Dublin specifically for that particular area.”
“If support is needed on these days, yourmentalhealth.ie has full information on emergency and out of hours supports available, including crisis phone and text support. I also direct people, particularly young people, to our new Navigator mental health support, Ireland’s online tool connecting them to personalised mental health information, resources and support.”
“For anyone currently supported by an eating disorder team, the HSE has confirmed that all teams will make arrangements with service users and families for days when services are closed. In addition, the HSE Self Care app will have additional guidance on how to manage during Christmas. Bodywhys has developed two excellent guides and a detailed podcast, led by a psychotherapist, with key information for people, families and carers on how to manage at this time of year. I encourage everyone to consult these guides on the Bodywhys website and will share this information with Deputies as needed. Bodywhys has also advised the Department of Health that their virtual support groups will meet as normal in December, and that their helpline service remains open over the festive period with the exception of public holidays.”
“The build-up to Christmas, the changes in routine and expectations around socialising and food can contribute to stress, pressure and conflicted thoughts and feelings for people. It is very important that people with an eating disorder who need help reach out to the range of community supports available to them. These include their own care practitioners including their GP and mental health teams and the eating disorder association Bodywhys, which I want to acknowledge. I am very happy to be able to support Bodywhys through the mental health budget. It does a lot of really important work on the interaction between Christmas and eating disorders. The Deputy mentioned Bodywhys Coping at Christmas guide.”
“That was a time we had one eating disorder team in place and two others funded, so we have made a lot of progress in relation to eating disorder teams in the community. We now have over 100 clinicians working on eating disorder teams, with eight consultant psychiatrists doing phenomenal work. We did see a huge peak in demand during the Covid-19 pandemic, especially young girls aged 15, 16 and 17 presenting with anorexia nervosa. The demand is there. The Deputy highlighted how Christmas can be a particularly challenging time for people with an eating disorder and their families for many reasons. For those living with an eating disorder, the festive season often does not bring the same sense of anticipation as it does for others, and it is important that we acknowledge this.”
“I thank the Deputy for raising this important matter. He is quite right that people look at Christmas in different ways. It is a really difficult time For some people. He is also quite right about the unique problems for people with an eating disorder and how they may feel more isolated than ever before. We have a national clinical programme on eating disorders, which has progressed well, with 16 teams funded, 14 teams up and running and the national roll-out having substantially advanced across some of those teams. Dedicated investment in eating disorders continues and the HSE has spent over €9 million annually on eating disorder services under the clinical programme. It is an area I have prioritised since I came into the role in June 2020.”
“I am very much of the view that every option should be explored. I will make contact with the HSE in the region to see that all options are explored on the future use of the premises. I am conscious of the issues the Deputy raised in respect of the health centre. My first priority is to the three residents at the facility in the context of making sure that they are moved on safely and securely and that they get the long-term residential care they need. My next priority is the 12 staff. This is a time of uncertainty for them. I will request that every effort be made to support the staff as they are relocated. Obviously, this can be a disruptive process for many people. I reiterate that I am happy to work with the Deputy to explore all options for the premises.”
“I understand the strength of the Deputy's feelings. As I said, he has been advocating for Erkina House for many years and also for the residents who live there and who called it their forever home. I understand how difficult it is for residents who have lived in a facility that they will have to move away from for several reasons. The Deputy has accepted that the building is no longer fit for purpose in the context of the provision of mental health supports. It no longer aligns with the mental health policy, Sharing the Vision, and HSE policies, including Time to Move on from Congregation Settings and Design for Mental Health Housing 2015 to 2017. However, I hear him loud and clear in relation to the facility. On many occasions, the HSE has moved out of facilities and they have been left unused.”
“At present, there are 12 staff based in Erkina House, five nurses and seven multitask attendants. Consultation with staff and their union representatives is planned for later this month to collaboratively negotiate and agree transition plans. This will be informed by the expressed will and preference of the remaining residents on their plans to leave Erkina House to go into further long-term residential care. In my concluding remarks, I will discuss the Deputy's concerns about Rathdowney and south County Laois and how we can work with him on investment in the area.”
“A person-centred management model has been implemented by the HSE, which has indicated that the remaining residents wish to move to other long-term care facilities elsewhere in the community. The HSE has advised the Department that this property is not suitable for upgrade and adaptation, and, accordingly, no new admissions to Erkina House will be undertaken. The HSE has provided assurances to the Department as to the service provision being made for the existing residents to properly meet their needs. I will not go over these details on the floor of the Dáil because the number of people involved is so small that the individuals involved would be identifiable. I would be happy to engage with the Deputy offline on that matter. It is important to address the situation with the staff.”
“The HSE has advised the Department and me that Erkina House would be significantly non-compliant with forthcoming Mental Health Commission community residence standards and that a significant level of investment would be required to develop the facility in order to achieve the additional regulatory standards required. An independent review was commissioned by the chief officer of the HSE midlands-Louth-Meath community healthcare organisation in 2022. The review was completed on the basis of a potential move of services to another location in County Offaly. This is no longer an option being considered by the HSE. The review strongly recommended that the views of residents on their future service provision be the focus of decision-making.”
“Erkina House is operated by the HSE as a fully staffed community mental health residence. The HSE has advised the Department that there are three remaining residents supported at the residence. Erkina House has provided much-needed mental health support to many people over two decades. I acknowledge the care and affection and immense mental health supports provided by the staff there. However, it is not the type of mental health facility we would build today. In that regard, there are documented issues with the configuration of the building as a mental health service. In 2018, a report by the Mental Health Commission inspectorate outlined the need for a significant response to multi-occupancy rooms. This was further recommended by the HSE for the purpose of infection prevention and risk control during the Covid-19 pandemic.”
“I thank Deputy Fleming for raising the issue of Erkina House. We have been here before. The Deputy has been a long-time advocate for and supporter of Erkina House. It is a key priority for me and for the Government that people experiencing mental health difficulties receive the appropriate level of care they require in the most suitable location in the community which best meets their needs. Achieving this involves reform of mental health services and developing fit-for-purpose community services that will meet people's needs into the future. I have just spent the past two and a half hours in the Seanad dealing with Committee Stage of the Mental Health Bill, and I will be back in there again tomorrow. It is important that we have services that are fit for purpose.”
“I thank the Ceann Comhairle and all the Whips for raising these important issues. We will take the opportunity on Thursday at the Business Committee meeting to discuss them further. The Order of Business stands.”
“and shall in any event be taken on the conclusion of the Parliamentary Questions to the Minister for Further and Higher Education, Research, Innovation and Science pursuant to Standing Order 47(1), with consequential effect on the commencement time for Second Stage of the Health (Waiting Lists) Bill 2024; and ( c ) the Dáil shall adjourn on conclusion of the Second Stage of the Health (Waiting Lists) Bill 2024; and 2. the proceedings on the Motion re Restoration of Private Members’ Bill to the Order Paper shall be taken without debate.”
“the ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the following extent: ( a ) pursuant to an Order of the Dáil of 2nd December, 2025, Parliamentary Questions to the Minister for Further and Higher Education, Research, Innovation and Science pursuant to Standing Order 47(1) shall be taken for 96.5 minutes immediately following the SOS; ( b ) topical issues may be taken earlier than 7.24 p.m.”
“the proceedings on Committee and remaining Stages of the Remediation of Dwellings Damaged by the Use of Defective Concrete Blocks (Amendment) Bill 2025 shall, if not previously concluded, be brought to a conclusion either at 12.22 p.m. or after 4 hours, whichever is the later, by one question, which shall be put from the Chair, and which shall, in relation to amendments, include only those set down or accepted by the Minister for Housing, Local Government and Heritage. In relation to Thursday's business, it is proposed that: 1.”
“the proceedings on the Motion to Instruct the Committee on the Remediation of Dwellings Damaged by the Use of Defective Concrete Blocks (Amendment) Bill 2025 shall, if not previously concluded, be brought to a conclusion after 60 minutes and the following arrangements shall apply thereto: ( a ) the order of speaking and allocation of time shall be as follows:- opening speech by a Minister or Minister of State – 10 minutes; speeches by representatives of Sinn Féin, the Labour Party, Social Democrats, Independent and Parties Technical Group, and Independent Technical Group – 7.5 minutes per party or group; speeches by Other Members – 7.5 minutes in total; and a speech in response by the Minister – 5 minutes; ( b ) members may share time; and ( c ) any division claimed thereon shall be taken immediately; and 7.”
“the proceedings on Committee and remaining Stages of the Irish Film Board (Amendment) Bill 2025 [ Seanad ] shall, if not previously concluded, be brought to a conclusion after 1 hour by one question which shall be put from the Chair, and which shall, in relation to amendments, include only those set down or accepted by the Minister for Culture, Communications and Sport; 6.”
“the proceedings on the Motion re Proposed approval by Dáil Éireann for a Council Decision to sign the Third Additional Protocol to the European Convention on Mutual Legal Assistance in Criminal Matters shall, if not previously concluded, be brought to a conclusion after 60 minutes and the following arrangements shall apply thereto: ( a ) the order of speaking and allocation of time shall be as follows:- opening speech by a Minister or Minister of State – 10 minutes; speeches by representatives of Sinn Féin, the Labour Party, Social Democrats, Independent and Parties Technical Group, and Independent Technical Group – 7.5 minutes per party or group; speeches by Other Members – 7.5 minutes in total; and speech in response by the Minister – 5 minutes; and ( b ) members may share time; 5.”
“the Statements on Online Safety shall not exceed 2 hours and 25 minutes and the order of speaking and allocation of time shall be as follows: (a) the arrangements for the statements, not including the Ministerial response, shall be in accordance with the arrangements contained in the table immediately below (to be read across, not down); (b) following the statements, a Minister or Minister of State shall be called upon to make a statement in reply which shall not exceed 10 minutes; and (c) members may share time; Gov SF Lab Gov SF Mins 25 15 10 10 3 SD Gov SF IPTG Gov Mins 10 10 3 9 10 SF ITG Gov SF OM Mins 3 9 10 3 5 4.”
“when the order of business shall resume with the Motion re Proposed approval by Dáil Éireann for a Council Decision to sign the Third Additional Protocol to the European Convention on Mutual Legal Assistance in Criminal Matters; and (d) the weekly division time shall be taken on the conclusion of proceedings on the Remediation of Dwellings Damaged by the Use of Defective Concrete Blocks (Amendment) Bill 2025, and the Dáil shall adjourn on the conclusion of the weekly division time; 2. notwithstanding anything in Standing Order 177(2), the proceedings on Second Stage of the Dog Welfare (Amendment) Bill 2025 shall, if not previously concluded, be brought to a conclusion after 2 hours; 3.”
“Gov SF Lab Gov SF Mins 20 20 20 12 4 SD Gov SF IPTG Gov Mins 20 12 4 20 12 SF ITG Gov SF OM Mins 4 20 12 4 20 In relation to Wednesday's business, it is proposed that: 1. the ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the following extent: (a) the time allotted for Government Business shall be extended in accordance with the arrangements for that business and the Dáil may sit later than 9.30 p.m.; (b) the SOS pursuant to Standing Order 25(1) shall be taken immediately following Taoiseach’s Oral Parliamentary Questions pursuant to Standing Order 47(1), which shall be taken at the time when the SOS would normally be taken; (c) in the event the Statements on Online Safety conclude before 5.20 p.m., the sitting shall stand suspended until 5.20 p.m.”
“the proceedings on the Second Stage of the Arbitration (Amendment) Bill 2025 shall be brought to a conclusion after 3 hours and 34 minutes and the following arrangements shall apply: (a) the arrangements for the first speaking round shall be in accordance with those contained in the table immediately below (to be read across, not down); (b) on the conclusion of the first speaking round or where speeches conclude before the 3 hours and 24 minutes have elapsed and no other member is offering, a Minister or Minister of State shall be called upon to make a speech in reply which shall not exceed 10 minutes, whereupon proceedings shall be brought to a conclusion; and (c) members may share time.”
“and shall in any event be taken on the conclusion of the Second Stage of the Arbitration (Amendment) Bill 2025, with consequential effect on the commencement times for the items following in the ordinary routine of business, namely, Parliamentary Questions to the Minister for Finance and topical issues; 2. the proceedings on the Motion re Excess Vote relating to 2024 [Vote 14] shall be taken without debate; and 3.”
“Thursday evening business shall be the Second Stage of the Health (Waiting Lists) Bill 2024, sponsored by Deputy David Cullinane. Proposed Arrangements for this week’s business: In relation to Tuesday’s business, it is proposed that: 1. the ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the following extent: (a) the time allocated to Government business shall be extended in accordance with the arrangements for that business and the Dáil may sit later than 10.48 p.m.; (b) Oral Parliamentary Questions to the Taoiseach pursuant to Standing Order 47(1) shall not be taken and Government business shall commence at the time when Parliamentary Questions to the Taoiseach would normally be taken; and (c) private members’ business may be taken later than 6.12 p.m.”
“and to conclude within 1 hour) - Irish Film Board (Amendment) Bill 2025 [Seanad] (Committee and remaining Stages) (to conclude within 1 hour) - Motion to Instruct the Committee on the Remediation of Dwellings Damaged by the Use of Defective Concrete Blocks (Amendment) Bill 2025 (to conclude within 1 hour and any division claimed to be taken immediately) - Remediation of Dwellings Damaged by the Use of Defective Concrete Blocks (Amendment) Bill 2025 (Committee and remaining Stages) (if not previously concluded, to conclude either at 12.22 a.m. or after 4 hours, whichever is the later) Wednesday's private members' business shall be the Second Stage of the Dog Welfare (Amendment) Bill 2025, selected by Social Democrats. Thursday's business shall be the Motion re Restoration of Private Members’ Bill to the Order Paper (without debate).”
“I move: Tuesday's business shall be: - Motion re Excess Vote relating to 2024 [Vote 14] (without debate) - Arbitration (Amendment) Bill 2025 (Second Stage) (to conclude within 3 hours and 34 minutes) Tuesday's private members' business shall be the Motion re Assessment of Needs, selected by Sinn Féin. Wednesday's business shall be: - Statements on Online Safety (not to exceed 2 hours and 25 minutes) - Motion re Proposed approval by Dáil Éireann for a Council Decision to sign the Third Additional Protocol to the European Convention on Mutual Legal Assistance in Criminal Matters (to commence no earlier than 5.20 p.m.”
“The Senator is right when she speaks about alcohol and how challenging that is for many people. I will conclude on that. I am ten years on my feet in the Dáil and Seanad and I have never been accused before of not having compassion.”
“The Mental Health Bill does not specify any mental health difficulty or mental disorder, including dual diagnosis. A person with a coexisting mental health difficulty and other issues can access inpatient mental health services where the person meets the criteria for involuntary admission. A person presenting with dual diagnosis is already accounted for in the current provisions of the Bill and should be able to access services based on need. I understand we have had lived experience that this was not the case previously, and it may not be the case in every single case. There are people who fall between the cracks. What I am trying to do is roll out incrementally is not a postcode lottery but dual diagnosis teams that can support people all over the country and a day hospital at Keltoi in Dublin to support people with dual diagnosis.”
“So I ask the Senator to temper her language in relation to what is being provided. She can speak to one particular case. I cannot. I have to speak in the round, but if the Senator wishes to bring that case to my attention, then I will see what I can do to support that person.”
“Every Monday morning, I get a report from the mental health unit of the Department of Health that tells me how many beds are and are not available. We have capacity where we need it to be at the moment. There is always an occasion where somebody might be waiting for a bed but every Tuesday of every week, representatives of the four regions come together and hold a meeting where they discuss the caseload for eating disorders, and if a bed is required for a child, then a bed is found. We also use private capacity, if we have to. I want to put on the record of the Seanad - it is important for me to say this - that since the clinical programme was introduced in 2018 for eating disorders for under-18s, we have not had to send one child outside of this jurisdiction for treatment.”
“-----and made a charge. I am thinking about those people and nurses who are working the night shift in Cherry Orchard tonight and looking after young people who are very sick with anorexia nervosa or some other eating disorder, or in Merlin Park in Galway or Eist Linn in Cork. I have visited each and every one of those places. For the Senator to come in and say that there are no eating disorder supports for people and young people in this country is factually incorrect and I would ask her to withdraw her comment because it is not true. There are 100 clinicians working on eating disorder teams across the country and there are nine consultant psychiatrists working. I monitor the CAMHS beds that are available every week.”
“The services are outpatient services because 90% of all eating disorders are best dealt with in an outpatient setting. Recovery is very slow and can take up to seven years. In Ireland, we have 51 CAMHS beds for children open at the moment and 22 of them are for eating disorders. I can bring the Senator to Cherry Orchard.”
“Senator Keogan has not spoken about the amendments we are discussing. She came in to make a point. I would like to make one back, which is that 90% of all eating disorders are best looked after in the community. We have 15 teams in place, 13 of which are resourced and two of which are the subject of recruitment processes. I recently went to Riverside House in south Dublin to open a facility with an adult team and a children’s team colocated. They are multidisciplinary teams, with consultant psychiatrists, psychologists, clinical nurse specialists, social workers and advanced nurse practitioners. The Senator can come in here and shout at me that there are no supports, but there are. An eating disorder is the toughest mental health challenge a person can have.”
“However, I am not going to leave this Chamber tonight with anyone believing that the Mental Health Bill precludes anyone with addiction issues from accessing mental health services where the admission is to treat the person’s mental disorder or mental health difficulty. The purpose is to treat their mental health issue, not their addiction, but there is recognition that they can be treated when they also have an addiction. The dual diagnosis element of what we are rolling out deals with both. We have to do more of it. I will not be accepting the amendments.”
“The Senator, having spoken to people who provide the services, tried to say that the services are being provided only to those with a mental health difficulty and a drug addiction. That is not the case. An adult with an intellectual disability, for example someone with Down’s syndrome who might have dementia and mental health challenges, will have a dual diagnosis. They are not going to be turned away. Therefore, I am not going to legislate for dual diagnosis when we are already putting the supports in place. I absolutely want to do more, and we will continue to roll out services across the model of care.”
“That is why I am not going to specify what dual diagnosis is. Dual diagnosis issues are being treated. I accept that the services are not where I want them to be. We are rolling them out incrementally year on year and building them up. One cannot say that an adult with an intellectual disability and mental health challenges cannot have an addiction also.”
“I would like to for a second because I cannot leave that unchallenged. The Mental Health Bill does not preclude anyone with addiction issues from accessing mental health services where the admission is for the purposes of treating the person’s mental disorder or mental health difficulty primarily. There may be addiction issues also, but such issues are not only about drugs. They can involve alcohol and gambling, and these relate to dual diagnosis also. I am working with a man who has mental health challenges and who is addicted to gambling. That entails dual diagnosis. It is not the case that dual diagnosis has to relate only to drugs. That is the first point. What the Senator is trying to say is that dual diagnosis is about drug addiction and mental health issues. It is not exclusively about them as there are many addictions.”
“The term is also frequently used to describe a person with a mental health difficulty and an intellectual disability. Defining dual diagnosis as a term that relates only to substance use problems and mental health difficulties would exclude other forms of dual diagnosis, creating unintentional confusion and service complications.”
“To the Senator's point, it is important to note that dual diagnosis is a broad term used in different clinical settings that does not only mean mental health and addiction services.”
“For example, when I came into the role in June 2020, we had three eating disorder teams: one up and running and two funded. We now have 15 eating disorder teams: 13 up and running and two more funded. We have 100 people working in eating disorder teams across the country, with ten consultant psychiatrists. When I came into post there were no supports for adults with ADHD. There was no clinical programme for adults with ADHD. We now have 14 funded ADHD teams for adults throughout the country. The last five are in recruitment so we are almost there. The point I am trying to make in relation to dual diagnosis is that it does not have to be listed in the Mental Health Bill for it to be happening every day of the week in trying to provide the services.”
“The supports for dual diagnosis are being put in place. I break my back every year. I have done six budgets in a row. I have increased the mental health budget by 50%. I am travelling to a jurisdiction tomorrow to discuss mental health care and all they want to talk about are the clinical programmes that we have in Ireland that are nowhere else in Europe, the clinical programmes we have in regard to eating disorder teams, mental health with intellectual disabilities, and perinatal mental health across every single one of the 19 maternity units in Ireland. All of these clinical programmes are in place. We are building on them. They have to be done incrementally. We are dipping into the same pool of staff for public, private and voluntary but we are making a lot of progress.”
“If a person needs treatment for his or her mental disorder, the fact that he or she has a coexisting addiction issue does not preclude him or her from being involuntarily admitted. It does not legally preclude them. Furthermore, any person may be admitted voluntarily, subject to the agreement of his or her responsible consultant psychiatrist. I highlight the fact that the Bill does not include any reference to any specific mental disorder. There will not be any reference to bipolar disorder or psychosis, but that does not mean the work does not go on in relation to eating disorder teams or self-harm and suicidal ideation. It does not mean we did not mention mental health with intellectual disability. It would not make sense to include a specific reference to dual diagnosis and dual diagnosis only.”
“Section 12 excludes a person from being involuntarily admitted in cases where he or she has addiction or substance misuse issues but does not have a coexisting mental disorder. It is a Mental Health Bill and the important point we have to get across is that, if you do not have a coexisting mental disorder, if you have a dual diagnosis but it does not involve mental health, that is the only time it excludes you from being involuntarily admitted. The simple reason for that is that a mental health service is best placed to treat mental disorders and a person with addiction issues is more appropriately treated in an addiction service, ensuring that the primary health concern of the individual is adequately and appropriately provided for.”
“Under budget 2026, funding has been allocated for Keltoi and for a dual diagnosis team. It will also provide more staff for the team in Waterford. Dual diagnosis is real but the model of care we devised in 2023, which took a lot of work, is actually there to support people with a dual diagnosis. That brings us back to the point to discuss exactly what dual diagnosis is. I want to clear up some misconceptions about the purpose of admission under the Mental Health Bill currently. People who have a coexisting mental disorder and an addiction or substance misuse issue can already access mental health treatment under the Bill. The Mental Health Bill does not preclude anyone with addiction issues from accessing mental health services where the admission is to treat the person's mental disorder or mental health difficulty.”
“The roll-out of the dual diagnosis community teams has commenced, with mental health funding of €5.4 million provided to support recruitment in this area to date. Five dual diagnosis teams have been recruited into and developed at present. Under budget 2026, I have allocated funding for an additional dual diagnosis team and a dual diagnosis day programme in Keltoi in Dublin. Some Senators will be familiar with Keltoi. That will be our day hospital. I have been working on this for the last two years. It is a day hospital which people with dual diagnosis in Dublin will be able to attend. The roll-out of the dual teams is progressing. An adult team in Limerick and Cork commenced services in 2024. A team in Waterford is in recruitment, with two other adolescent teams currently being developed in Dublin.”
“In relation to improving access to dual diagnosis services, Government policies, including Sharing the Vision and Reducing Harm, Supporting Recovery, set out clear commitments to improving services for people with a dual diagnosis. Sharing the Vision recognises that people with a dual diagnosis should have access to appropriate mental health services and supports. A Vision for Change did not include that. That was one of the fundamental differences because Sharing the Vision is my bible and my job. I am tasked by the national implementation and monitoring committee, NIMC, to implement it. It is not gathering dust on a shelf. I travelled to Limerick last Thursday week for the third meeting of NIMC this year. It travels the country and goes to various different areas to see that.”
“I thank Senator Ruane for her presentation for sharing her lived experience. I understand how passionate she feels about this. She is telling me I have an opportunity relating to dual diagnosis. I have been in this role since June 2020 and the first thing that was presented to me when I came into it was a copy of Sharing the Vision, our mental health policy. That strategy puts the service user front and centre, was cross-departmental, recognised lived experience and peer support, and also recognised dual diagnosis. In 2023, I was the Minister of State who launched the model of care for dual diagnosis, jointly with the then Minister of State, Deputy Naughton. It recommended the development of 12 adult specialist dual diagnosis teams nationally and four adolescent hub teams. It is important to put on the record what has been done.”
“I do not think that is pharmacological restraint but I believe it is for the best people to determine what it is and what way it should be implemented properly because there have been incidents and I myself have come across them. You might have older people with dementia. You might have an adult with an intellectual disability, for example, who might be a risk to himself or herself or a risk to others, and it is in that determination where I felt it was important enough that pharmacological restraint needed to be included in this Bill and I want to take the advice of the Mental Health Commission in relation to it. I thank the Senators for their amendments. I have looked at them in detail but I would prefer to continue on the pathway. We all are 95% on the same page. That is where I am at.”