2025-12-09

I am not sure if the Minister of State was in LH 2000 earlier for the lighting of the Christmas tree. It was a lovely event that kicks off the Christmas celebrations for many. Christmas offers a chance for families around the country to come together and reconnect. However, it can also be a time of additional emotional stress and pressure. I refer to the pressure of additional spending for those already struggling to make ends meet, the feeling of loss for families struggling with the death of loved one during the year gone by and the loneliness experienced by those who live on their own. For those with living with eating disorders and their families, the Christmas season can bring huge pressure. As we approach the holidays, we have to acknowledge that Christmas can present unique challenges for these people. Pressures around food, social gatherings and changes in routine always intensify during this period. While many look forward to celebrations that involve food and drink and the social expectation to get involved, having to do so puts those who are suffering in an uncomfortable spotlight. People with eating disorders can often feel more isolated than ever at Christmas. They can be more aware of their own feelings of inadequacy and the depression and worry associated with their disordered eating. As the Minister of State knows, eating disorders affect up to 5% of the population at some time in their lives. One of the challenges of supporting these people is that the supports they need cross the traditional divide between mental and physical supports and health services. I have met advocacy groups working in this area and have heard very strong testimonies from those who have experienced these conditions and their families, who have worked so hard around the clock to support them. Young people are particularly vulnerable at this time of year. When schools close, key protective structures in those schools disappear. Teachers and guidance counsellors often play a stabilising role in a student's life, an influence that is absent for weeks during the holidays. Routines matter for these people and when they are disrupted, additional challenges arise, intensifying distress and anxiety. I want to ask and examine how supports can be strengthened during this vulnerable period and if the Department of Health has considered issuing any specific guidance for families and individuals living and dealing with eating disorders over Christmas. Families need reassurance and practical advice. I want to acknowledge the excellent work done by Bodywhys, in particular their Coping at Christmas guide, which is a practical piece of work that offers strategies to those struggling to manage the stress associated with Christmas and to plan ahead.

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. 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. 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. 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. 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.

I thank the Minister of State for her response, and I acknowledge the development and service development work that has gone into this in the past number of years. As she set out, we started from a very low base, but it is hugely positive that the service is being developed. It is important we recognise the challenges that many people face in our communities. Reduced service hours during the Christmas period has the potential of having a really negative effect and I really welcome the commitment from the HSE and the confirmation that teams will make direct arrangements and communicate. That is very positive. I appreciate that significant progress has been made through the national clinical programme. If these specialist services and structures are built, it is important they be available to people at those periods of heightened vulnerability like Christmas. Looking beyond Christmas, the review of the model of care for eating disorders will be crucial in improving how we respond to those challenges and I noted in a recent response to a parliamentary question that the bed capacity review is back from the HSE and is with the Department and the Minister of State. Can she give us any insight as to what that looks like? In-patient bed capacity is absolutely vital for dealing with all elements of these cases. It is an area that is complex, long misunderstood and that has been underinvested in and under-resourced. It is great to see resources going in. We must learn from those lessons coming through the national clinical programme and deliver evidence-based, dependable and well-co-ordinated services that support recovery from eating disorders at every stage in the life cycle. I thank the Minister of State for her work to date and urge her to prioritise clear communication, good strong solid community supports and renewed commitment to getting full implementation of a revised model of care once it is agreed.

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. We conducted the bed capacity review and I was delighted to work with the Minister for Health, Deputy Jennifer Carroll MacNeill, to secure significant capital investment from 2026 to 2030 sitting somewhere around €400 million for mental health. I have never had that kind of funding available to me before for capital investment. As a result, we will invest in 20 adult beds. We will locat them geographically. From memory, there will be approximately eight to ten beds in the Dublin region, six in the Cork region and another approximately six in the Roscommon region. The reason they are located like that is these are three areas we have identified and approved for building new centres with departments of psychiatry where we will include these beds. The most important thing is that a person does not have to be living in that particular area to access a bed. That is a specific problem we have at the moment with St. Vincent's Hospital. I am really pleased we will be able to move this on. It does take time, but we are certainly making progress.