Dáil debates

Thursday, 3 October 2024

Ceisteanna Eile - Other Questions

Eating Disorders

11:10 am

Photo of Violet-Anne WynneViolet-Anne Wynne (Clare, Independent)
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6. To ask the Minister for Health to consider providing funding in budget 2025 for a mental health services adult and children eating disorder team in the mid-west under the new national model of care; and if he will make a statement on the matter. [39431/24]

Photo of Violet-Anne WynneViolet-Anne Wynne (Clare, Independent)
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Will the Minister of State consider providing funding in budget 2025 for a mental health services eating disorder team for adults and children in the mid-west under the new national model of care?

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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As the Deputy will know, the model of care for the national clinical programme for eating disorders was launched in 2018 and since I took office in July 2020, I have prioritised its roll-out. Multidisciplinary eating disorder teams for adults and CAMHS are being rolled out throughout the country. There are now 11 teams in place, comprising six adult teams and five for child and adolescent mental health services. Earlier this year, I announced the establishment of a new adult team for CHO 7, which will cover the areas of Kildare-west Wicklow, west Dublin, south Dublin city and south-west Dublin, bringing the number to 12. To date, more than 100 posts are funded under the national clinical programme. More than 80 eating disorder clinicians, including ten consultant psychiatrists, are now treating people with eating disorders. Last year, the HSE made a dedicated investment of €8.1 million under the clinical programme.

As for the Deputy’s question about CHO 3, when I was meeting all the clinicians prior to the budget, I put a heat map on the wall and we looked at areas in the country that did not have these services, and that is where my priority went in this budget. I have good news for the Deputy this morning as I am pleased to confirm that under budget 2025, I have allocated funding for a further two eating disorder teams next year, which will include a CAMHS team in the mid-west. This will bring the total number of teams nationwide to 14. CHO 3, therefore, covering Limerick, north Tipperary and Clare will get an eating disorder team for CAMHS, which will comprise ten whole-time equivalent staff. I am delighted to be able to give the Deputy that information.

Photo of Violet-Anne WynneViolet-Anne Wynne (Clare, Independent)
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I thank the Minister of State. That is fantastic news. My response was going to outline that ours is the one region that does not have a team in place, so that is significant. I appreciate that the Minister of State has prioritised this area since she took office. I put this question to her because Mind EveryBody and Cared Ireland gave a briefing in recent weeks in the audiovisual room and the lived experiences of those with eating disorders, as well as the personal consequences and impact on them and their families, struck a chord with me. I wanted to point to Ciara Greene, who has more than 20 years' experience. She has had a number of struggles over recent years. There were some awful stories, with speakers reporting that they had been told they were seeking attention. I wanted to bring that to the Minister of State's attention because it is serious and concerning.

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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Since the model of care was launched in 2018, we have learned that 90% of those with an eating disorder can be treated very well in the community. We saw a huge spike in the number of referrals for eating disorders during Covid, especially in girls aged 15 or 16 with anorexia. As I said, year on year I have continued to prioritise the roll-out of these teams, which are specialist teams. People who work with eating disorders have specialist qualifications, and the fact 100 people are working on a specific clinical programme for eating disorders is very welcome. I was conscious the area in question did not have a CAMHS team and it is important that that will be done. Six posts will also be allocated to the adult eating disorder team in CHO 5, my own area. There are four posts at present but a further six will be added to enhance that team.

Photo of Violet-Anne WynneViolet-Anne Wynne (Clare, Independent)
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I seek clarification. We will have a CAMHS team but I am conscious of the need for a pathway for adults to get services. Will that remain a gap to be prioritised next year?. At least 200,000 people in Ireland suffer from an eating disorder and there is an issue with the availability of inpatient beds. While the Minister of State alluded to community care, which may be fantastic for many who need it, if they need that specialised care and treatment, inpatient beds are the only place where they can get that, as far as I understand. Currently, there are only three and they are all located on the east coast. Is there any opportunity in this budget to increase the number of inpatient beds for the mid-west?

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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As Deputy Wynne noted, there are currently only three specialist inpatient beds for adult eating disorders in the State. As the Minister of State will know, eating disorders are one of the most fatal mental health problems people can have. Patients are being admitted into non-specialist wards, having their body mass index increased without specialist help and being released back into the community they came from, and this cycle is happening over and over again. If they are lucky, they will go back into that cycle, but sometimes people fall through the cracks, as the Minister of State will appreciate.

Will there be an increase in the number of inpatient beds in budget 2025, and if so, where will they be located?

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
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To what extent will the Kildare-west Wicklow section to which the Minister of State referred see a noticeable improvement such that patients and potential patients can put their minds at ease, with specific reference to access and follow-up?

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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Approximately 90% of people with eating disorders are treated in the community. The best clinical advice that was available to me when I took up this role suggested that we should enhance the clinical supports in the communities because that would meet the needs of that 90%. We are undertaking a review of the model of care because when it was devised in 2018 with data from 2016 and 2017, it was estimated that there might be 60 people a year, whereas we are now reaching more than 500 people a year who have an eating disorder, which is a serious mental health illness.

A total of €2.2 million as a full-year cost is being provided for the new eating disorder teams. They are expensive to put in place. It amounts to €1.1 million as a half-year cost. It takes between 12 and 14 months to recruit the teams and put them in place.

To respond to Deputy Ward, again I prioritised the community. What we are considering in respect of eating disorder beds will form part of the review, but I am clear that there will have to be a geographical spread.

We have three beds in St. Vincent's hospital, which serve only that particular area. It is really important that when we put those facilities in place, there is a geographical spread. We want to ensure that whichever area people live in, they have access to a bed within an hour's travel.