Violet-Anne Wynne (Clare, Independent)
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10. To ask the Minister for Health his views on the increase in attendances at University Hospital Limerick, especially those who are in need of mental health support; and if he will make a statement on the matter. [25771/24]

Violet-Anne Wynne (Clare, Independent)
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What are the Minister's views on the increase in attendances at University Hospital Limerick, especially those who are in need of mental health support, and will he make a statement on the matter?

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for her question. The Government has invested significantly in University Hospital Limerick. Since the start of 2020, staffing at the hospital has grown by more than 1,200, an increase greater than 40%, and more than 100 beds have been opened on the site. The Minister, Deputy Donnelly, is also keenly aware of the increasing demands nationally on our emergency departments and UHL has not escaped this trend, with a 10% increase in attendances from January to May 2024 compared with same period last year. While a breakdown of data on reasons for attendance is not available, a proportion of those attendances will be for mental health.

Key service enhancements under way in mental health services in the mid-west will reduce the need for ED presentations for mental health reasons. These include an additional CAMHS team for the region, and a CAMHS hub, which is a consultant-led multidisciplinary support that is an alternative model to providing inpatient care, with treatment at home or in a day hospital. One of these is already operational in the west and it works very well. Supporting people with enduring mental health conditions in a day hospital means they can go home every evening, sleep in their own bed and have the support of their community and family. For those experiencing addiction or homelessness, key new services include a dual diagnosis team, commencing next month, to treat people who have a mental health diagnosis and experience addiction.

The Minister, Deputy Donnelly, visited UHL again in early April and met with senior management, doctors and nurses. He announced a package of actions to alleviate the pressures at UHL and to support staff in implementing reforms to work practices to better suit patients.

In that region we will also shortly open a solace café or a kind of crisis café, which we have done in Cork and in Galway. We know from figures received that it reduces the number of people who need an intervention and they do not have to attend the emergency department.

Violet-Anne Wynne (Clare, Independent)
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I really appreciate all the information. It is welcome to hear about this solace café, the CAMHS hub and the additional team. I queried how many under-18s presented at the UHL emergency department with mental health issues and the data shows that the numbers have increased, which is a huge concern to me. In 2023, for example, 173 under-18s presented with mental health issues or as being at risk of suicide or self-harm. I believe they are presenting in crises and the emergency department is not the best environment for those cases. I appreciate the information the Minister of State supplied, which is very welcome. I have data showing there has been an increase of 14% in the people presenting at the emergency department in UHL versus the same period last year. Among the over-75s, trends show the presentations have increased by 15% and the number of patients on trolleys has increased by 49%. This is in stark contrast to the reduction in all other emergency departments. I know the Department is developing a national reform framework and I ask the Minister of State to speak to that in her contribution.

Mary Butler (Waterford, Fianna Fail)
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I will give a bit more information on mental health supports in the region. Since 2022, a total of 16.6 whole-time equivalents have been recruited across CAMHS in the mid-west. The number of CAMHS-registered consultant psychiatrists in the mid-west has increased to 6.2, up from 3.6. As the Deputy knows, we had challenges in that area due to retirements. I am glad to say we are back up to six there again. As I said, an additional CAMHS team is in development for the mid-west. We spoke previously about the challenges in the Clare area and the amount of travel. This will bring the total number of CAMHS teams to seven across the whole mid-west.

As I said, a CAMHS hub is in development. This is a consultant-led multidisciplinary support that is an alternative model to providing inpatient care, with treatment at home or in a day hospital. We have seen a spike in the number of presentations, with young people being referred to CAMHS teams. Having this type of alternative to an admission to hospital is very welcome.

Violet-Anne Wynne (Clare, Independent)
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We have discussed this previously. After that team has been set up, we could possibly look at a further team for the west of Clare, just because of the geography and how far they are from other kinds of supports. The full-capacity protocol was triggered every single day of 2023 in UHL, again pointing to the emergency department not being the best place for those patients. I also queried how many people leave the emergency department each month of the year and the numbers were stark, with in excess of 500 people month on month. July showed the highest number at 656. It was significantly higher for UHL than any other hospital bar the three main Dublin hospitals. That again points to UHL being a major anomaly, as the Minister has indicated. In 2009, HIQA recommended the closure of Ennis Hospital as insufficient numbers of patients were presenting to maintain healthcare staff's clinical skills and expertise. However, we also know from the regional health forum that 25% of presentations to UHL, nearly 8,000 people, are from Clare.

Mary Butler (Waterford, Fianna Fail)
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I want to touch on the dual diagnosis service which is due to commence in July 2024. Last year I announced the new model of care for dual diagnosis, something Deputy Gino Kenny has raised with me on several occasions. This is the treatment of people with a mental health diagnosis who also experience addiction. We have also been working with the Department of Justice on this. It is important that people with dual diagnosis whom we divert away from prison get the appropriate support. The dual diagnosis service is due to commence in July 2024. This is the second one in the country, which is very welcome.

I want to speak briefly about the Pathfinder. When someone dials 999 for an ambulance and the paramedics come to their home, the Pathfinder is available in Limerick. It avoids the hospital emergency department. They come to the home and they are able to provide all the tests. They are able to provide IV drugs. They are able to do the blood test, urine dip and everything that is needed. The Minister, Deputy Donnelly, and I are anxious to continue to roll that out across the country. It really supports people's mental health when they can stay in their own homes in their own beds.