2026-01-14

As the Minister of State knows well, County Wexford is experiencing a mental health crisis due to the lack of an acute mental health facility since the closure of St. Senan's psychiatric hospital in 2013. This facility served as the primary mental health institution in the region for over 150 years. There has been no replacement, meaning there is no acute mental health unit in Wexford. This is shocking in the context of the escalating mental health crisis we are witnessing nationwide. It is deeply troubling and leaves a significant gap in service provision in the south east. I was alarmed by information I received. While I knew this already, I wanted to confirm the exact figures by means of a parliamentary question before Christmas. The response showed that over 1,000 people had presented to Wexford General Hospital's accident and emergency department in mental health crisis between January and October 2025. Over the past five years, Wexford's accident and emergency department has seen 5,105 patients presenting in mental health crisis. It is incredible that 877 of those who presented to the hospital in mental health crisis were children. What is truly terrifying is that these thousands of people had no dedicated mental health facility available locally. I live on the Wexford-Wicklow border. It is a long way from Waterford hospital. In my office, we received far too many reports of patients waiting and being referred to an antiquated psychiatric department in Waterford city, only to be discharged or often refused services within hours due to a lack of staff or lack of space. I am sure the Minister of State will agree it is completely unacceptable to have these circumstances in 2026 in a country that is awash with money. My background is primary teaching and I am involved in secondary schools. The Minister of State will accept that this antiquated psychiatric unit in Waterford hospital is a completely inappropriate setting for children in a mental health crisis to be sent to, especially if they are travelling long distances, for example, from anywhere in Wexford or even south Wicklow. The Minister of State has responsibility for mental health. I ask that funding be allocated through the HSE capital programme for the development of a mental health unit attached to Wexford General Hospital. This issue is regularly brought up on South East Radio. All the Deputies present will agree with this proposal. All 34 councillors in County Wexford agree with it. It comes up at practically every meeting of the county council and there is cross-party support for it. We need to see movement on this unit in 2026. It is urgently needed to ensure that people in acute mental health crisis can access timely, appropriate and safe care close to their home. County Wexford has repeatedly been left behind in terms of mental health services. This is not only failing the people experiencing the crisis, but also their families. We need a whole family support and wraparound service. There are partners, parents and carers struggling to navigate a fragmented system while supporting loved ones in crisis. They require accessible counselling, education and practical supports to help them to understand and manage the challenges they face. The Government has paid lip service to mental health provision and well-being. It has failed to deliver A Vision for Change and Sharing the Vision. The result is that many of facilities are in a state of emergency. Funding has stagnated and reform has stalled. What plans does the Minister of State and the Government have to address the mental health crisis in County Wexford? I know all about Waterford and the overall budget, but the money does not appear to be going to Wexford in any meaningful way. I would be grateful if the Minister of State could comment on that.

I thank the Deputy very much for his question. I am quite disappointed at how the Deputy has presented the situation in Wexford. I think of all of those who are working in mental health services in Wexford today. They would be disappointed by the Deputy's statement that Wexford has been completely left behind in relation to mental health services. I will approach this issue in three different ways. First, as the Deputy knows, we have six new regional health areas. Community healthcare organisations, CHO, 5 and 6 have been amalgamated and broken down into three substructures. Waterford and Wexford are amalgamated under one integrated healthcare area, IHA, manager, Dr. Sinéad Reynolds, whose background is in mental health. She is a strong advocate for mental health. I will meet Dr. Reynolds in the next two weeks to discuss mental health services across Waterford and Wexford. I take umbrage with how the Deputy portrayed the department of psychiatry led by the clinical director, Dr. Vwoke Akpubi, in University Hospital Waterford. On two occasions, the Deputy said it was an antiquated service. That is not true. Maybe the Deputy meant the building, but the service is not antiquated. St. Senan's closed in 2013 before the Deputy and I became involved politics at national level. When St. Senan's was closed a decision was taken that all referrals would be made to University Hospital Waterford. There are 42 beds in the department of psychiatry at University Hospital Waterford. We also have a service-level agreement with St. Patrick's in Dublin. I know this inside out because I have lived it for the last five years as Minister of State with responsibility for mental health. We have a service-level agreement with St. Patrick's, a private hospital in Dublin, when we have issues with capacity. The Deputy has spoken about the number of presentations of children to emergency departments in Wexford. As he will know, when Wexford General Hospital had a fire a year and a half ago, University Hospital Waterford partnered very closely with it to take any of the overflow that could not be dealt with at that time. In response to the Deputy's comment that the unit is antiquated and not suitable for children, only two children were admitted to an adult department of psychiatry last year across the whole country, down from 100 when I took over in 2020. There were two cases last year, taken in real time when a clinician - a consultant psychiatrist - had to make a life or death decision on whether to admit that child or young person. In both cases, the patients were 17-plus and they were admitted with the approval of their parents. I cannot let that hang in the air. Wexford is being very well served by community mental health teams. There are six adult community mental health teams, one in Maryville, New Ross, two in Carn House in Enniscorthy, one in Tara House, Gorey and two in Summerhill in Wexford town. There are also two CAMHS teams and there are plans to put a third team in place. That said, I do accept what the Deputy has said in relation to the fact that there are no adult psychiatric beds. That is the nub of the issue in Wexford in general. Indeed, this has been raised with me by the Minister for housing, Deputy Browne, on several occasions and by other public representatives in Wexford. I want to give a shout out to Mental Health Ireland which is very strong in Wexford. Over the last five years I have launched many of its initiatives in relation to mental health, well-being, and emotional distress in the Wexford area and I want to applaud it for all the work it does on the ground. To go back to what the Deputy has said in relation to acute beds, I am aware that there are none in Wexford. I am also aware that there are none in Tipperary. We have done a capacity review of mental health beds and we will be having a look at this in the new year.

I acknowledge what the local teams are doing. They are doing brilliant work at Tara House, Arden House and lots of other places. I am glad to hear that the Minister of State accepts that there are no acute beds in County Wexford and that she will look at that this year. I am just reflecting what every politician in Wexford is saying and what the people coming to me are saying. They are saying that the facility in Waterford is not appropriate. I am not disparaging the work that they are doing. They are doing brilliant work under very difficult circumstances. I know this from a local county councillor who was bringing his own son. He said that it was so difficult. It was not possible to bring him by car because he was likely to jump out so he had to be brought by ambulance to Wexford. This is a county councillor in Wexford who will not mind me saying this because he has raised it publicly himself. I am just saying that the setting is inappropriate. That is his view. He has been campaigning on mental health for many years and has said that it is completely inappropriate for children. I also believe it is inappropriate. It is not a proper setting for someone in crisis. When people in mental health crisis present at Wexford General Hospital, the staff there do not have the training, resources or expertise to be dealing with them. I applaud the absolutely incredible work being done by groups like It's Good 2 Talk and Talk to Tom up in the north of the county. I have been dealing with Talk to Tom for years and have often referred children to it because it does brilliant work. However, Talk to Tom has not received one cent in statutory funding since it was set up. It organises local fundraisers. It is crazy that a local, voluntary group feels that it must step in to fill the gaps left by the State, a state that is awash with money. I was just looking at figures today showing that over €4 million was spent on security for a facility that was going to be used by IPAS across the border in County Wicklow. That is just one example but I could list hundreds of other examples of where money could be better spent. It is completely inappropriate to be wasting people's money. Some people say that it is not practical to have an acute facility in County Wexford. I disagree with the Minister of State's previous statement that it is not practical to have a facility in every county. I would be grateful to hear more about what she could do in that regard.

I am trying to count to five here because, as I reiterated, only two children across the whole country were admitted to adult wards last year. Two 17-year-olds were admitted, with the consent of their parents, for their own safety. There are no children being admitted to the department of psychiatry at University Hospital Waterford. That is the first thing I want to put on the record. Second, when we are finished here I suggest that the Deputy takes a look at the Mental Health Commission's report on foot of its visit to the department of psychiatry at University Hospital Waterford last year and the results therein. I am not going to leave it hanging in the air that there is a service in Waterford that is not fit for purpose because that is not the case. On three occasions, Deputy Ó Súilleabháin has disparaged that service. I know the teams that work there and I know the work they do. As the Deputy knows, under the capital plan there will be a new-build unit in University Hospital Waterford. A new 50-bed department of psychiatry is in the capital plan and has been progressing, albeit slowly, over the last three years. It was meant to be adjacent to the hospital. The consultants there and the executive clinical director wanted it to be part of the hospital and that is exactly what is going to happen. We must acknowledge the work being done by all six general adult teams in Wexford, the psychiatry of later life service in Wexford, and the two CAMHS teams in the county that I have visited. I also want to acknowledge the services that are available, including the liaison services through Wexford General Hospital. We cannot underestimate the services that are being provided. The issue the Deputy raises today relates to acute mental health beds in Wexford. There are none currently planned but we are certainly going to look at the issue, perhaps in the context of a crisis house or a high-level hostel. It is on my radar. I will give the Deputy that but I want to acknowledge the good work that is done in the department of psychiatry in Waterford.