Victor Boyhan: 50 Central Mental Hospital beds empty, families warn

Thank you, Cahillac. Well, firstly, I want to welcome the Minister yet again back to the Senate. It's always good to see you, and I want to thank you personally for coming here to deal with this commencement matter, which falls within your remitter and your responsibilities. So I suppose I just want to set the scene here because I think it's really important. Ironically, I had put this commencement matter down for yesterday, but it wasn't selected. But I'm sort of glad it wasn't selected because today I'll be quoting from Alan Mitchell, George Alan Mitchell, because there was a posting on RTE at 10 past 12 yesterday, which I thought was really interesting because it actually relates to very much the point I'm going to make. So anyway, I'll just go ahead. I suppose, Minister, you know, watching the RT Investigates programme, and I think you may have said or I may have said to you that we had watched it, it was about two weeks ago or never, that the psychiatric care scandalous was entitled the RT Investigates programme. It was over a period of two nights. It was, to say at the least, very disturbing. But I think it was very necessary viewing. And I suppose this harrowing documentary laid bare the reality of what the Irish Penal Reform Trust had regularly told us as politicians in both houses of the Oireachtas, as did other advocacy groups. The anguish of family members who fear for the well-being, and in many cases, in instance, the lives of their loved ones experience severe mental disorders, and the health crisis around all of that. People in the criminal justice system crying out for help that never came, in many cases. Families watching their loved ones physically and mental health dramatically deteriorate. And I suppose Conor Ryan, the RT Investigates programme, retelling the stories of families' grief and pain flowed through the screen into our homes. And I suppose it was really public broadcasting, maybe at its saddest, but at its best, because it shone a light in a very dark place, and it acted as another focus or advocacy in terms of the crisis that we're referring here to today. So I want to acknowledge Conor Ryan's professionalism in RTE primetime, and RTE itself for the amazing investigation programmes it's done. And RTE primetime investigates, of course, exposed that many families, clinicians and advocate organisations have been telling us, as I said, for years. The state is relying on prisons to manage many, not all, but many people with severe mental illness. The state is failing to provide adequate and inappropriate healthcare, despite our domestic and international human rights obligations, including the European Convention of Human Rights and the EU Convention on the Rights of Persons with Disabilities. The RTE documentary highlighted people who had already been diagnosed with serious mental health conditions. Some were bipolar, some had schizophrenia, others were experiencing psychotic episodes, yet despite being in touch with mental health services, they were denied the support and the appropriate and necessary treatment that they clearly required. The HSE and the National Forensic Mental Health Service is clearly under-resourced and overwhelmed. I've spoken to the people involved here, directly, some of them, and this is what they tell me. You know, Minister, and I know, and agree, I think, on this, that prison is not a therapeutic place. It cannot address the trauma nor heal people who are unwell. Prison staff are not fully equipped. or to support people with specific psychiatric healthcare needs, and we accept that. The Central Mental Hospital is a facility that cost approximately $250 million when it was built. It was then, in its press release, an announcement by government, it was talked about in the frame of a new change in a new direction, and one that we all welcomed. One-third of its facility units are not opened, I understand, as of yesterday. Fifty beds remain empty, while people remain in squalid prison conditions. I want to take this opportunity to thank Saoirse Brady of the Director of the Irish Penal Reform Trust. I finish at one point. Alan Kelly, in a quote in yesterday's Irish Times, says, Judge Alan Kelly, to be precise, No options for psychiatric patients held in prison, Judge warns. And it goes on to say that a solicitor before him from the HSE, named Alan Doyle, told him in a court of law that it was hoped that 10 beds at the CMH would be opened at the end of March, but he could not confirm if this was actually the fact that was actually going to happen. So, Minister, look, I'm here to work collaboratively with you, and I know you are with me. And I suppose my focus is really when we can get these 50 beds, gradual and all as it might be, when we can get us up a time frame for their opening. Thanks. I want to begin by acknowledging the concerns raised in the recent Primetime Investigation Programme on Forensic Mental Health Services. While I'm not a clinician, my responsibility is to maintain public confidence in this essential service for a highly vulnerable group of patients and for the dedicated staff who care for them. I have asked the HSE for full reports on the cases highlighted in the programme, particularly those involved in the Central Mental Hospital. I have also asked that all appropriate care options for individuals featured be examined. I want to recognise the pain expressed by the families who took part. Their lived experience matters, and it motivates me to continue improving the system. It is important to restate that the Central Mental Hospital is a hospital, it's not a prison. Its purpose is to provide treatment, support rehabilitation, and enable a safe, carefully managed return to the community where appropriate. Demand for forensic mental health services has grown significantly in recent years, including increased need for inpatient beds at the Central Mental Hospital in Portran. The HSE actively manages the admission waiting list and works closely with the Irish Prison Services to prioritise those with the most urgent clinical needs. Senator, the very first piece of legislation I moved in at the end of 2020 was the legislation to support those living in Dundrum and the Central Mental Hospital to be transferred to Portran. In 2022, I opened the new Central Mental Hospital at Portran, transferring 93 patients from the old Dundrum facility. This state-of-the-art campus, which cost £220 million, is one of the best, if not the best, of its kind in Europe, was delivered actually with £212 million in government capital investment. The 170-bed complex included a 130-bed Central Mental Hospital, a 30-bed Intensive Care Rehabilitation Unit in Icrow, and a 10-bed Forensic Child and Adolescent Mental Health Services CAMHS unit. It was always intended that the full capacity at Portran would become operational on a phased basis, because these are very dedicated, specific staff. There are currently 114 operational beds at the CMH, a 20% increase on the former Dundrum Hospital. In Budget 2025, I secured €2.1 million to recruit the staff necessary to open the remaining 18 Central Mental Hospital beds. 112 were operational at that time. The National Forensic Mental Health Service was permitted to recruit directly, and filled most of these specialist posts in record time. There were 45 posts, 41 for the hospital, 4 for in-reach into prisons. These beds will open gradually over the coming weeks and months, so two beds opened in December, and other beds will open in the next few weeks. When all 130 beds are operational, overall Central Mental Hospital capacity will have increased by 37% since late 2022. In Budget 2026, I allocated a further €2.8 million to fund 30 additional staff to open the first 10 beds in the new ICRIL, the Intensive Care Rehabilitation Unit. Bringing these beds into use will support smoother patient movement through the Portran campus, different levels of care, helping create spaces for further admissions. This year's funding, and I think this is important to note, this year's funding will bring the National Forensic Mental Health Services workforce to approximately 580 staff. When the ICRIL beds open later this year, the campus will operate 140 beds, an increase of 45 beds, or almost 47% more capacity compared with Dundrum. The investment will significantly reduce the current waiting list of 38 people in prison who need hospital care. We also have two psychiatric intensive care units, Carrick Moor and Cork, and the Phoenix Centre in Dublin. While these provide short-term intensive care, ICRILs offer both intensive treatment and longer-term rehabilitation. Minister, I want to thank you for coming here, as I said, today. I want to thank you for your comprehensive statement there. But the reality is that there are facilities that have not been opened in the facility. There were 50 beds remain empty, while people remain in squalor conditions in our prisons. And yes, there's been a lot achieved, and I'd be the first to say that. But the reality is we need to have these 50 beds. We have budgeted. The taxpayers are paid. We have this in place. So I really think it's important that we prioritise. And I hear your point about incremental increasing, but I'd like to be in a position to say, or I'd like somebody to be in a position to say at the end of the year, we fill these 50 beds. So I draw your attention to this article, which I will send your office. You may or may not have seen it, but on the RT News yesterday, player. No options for psychiatric patients held in prison, Judge warns. Now, he was having a hearing in Cloverhill, caught in the prison. He is now saying he's going to have to look at alternatives. So I think it's really, really important. And the solicitor for the HSE, Alan Doyle, is on the record as saying that 10 beds will open, hopefully by the end of March, but he's not in a position to confirm that. I mean, could we be ambitious and say that we'd have 30 beds open this year? I'm not asking you to say that now, because clearly you're going to have to think about it and talk to the people on the ground, et cetera. But we have the facility. We have the beds. You know, they're there. Let's open them. Because, you know, if we learn anything from prime time, we cannot in a few weeks, and I have no doubt they'll be following this story here today. We know there is a story, and I think it's important that we are ambitious enough to fill the 50 beds that are in place in this facility. I don't think you listen to my answer, Senator, to be fair. And I am ambitious enough, and I can give you the response. Because I'm the person that secured the funding last year to hire 45 additional, very specific staff to work in the National Forensic Hospital. So, you know, there's not that these staff are sitting on unemployment lists all over the country. They're hard to get. That's the first point. We recruited the 45 of them, 41 of them, to open 18 beds. So we open two of them in December, and we will open the other 16 on a gradual basis, which is undergoing at the moment, and we should have them all opened, those additional 16 by the end of March. In Budget 2026, I secured... This is a different type of bed now, you see. This has been lost in the whole debate. The Intensive Care Rehabilitation Unit. These are the most sickest people in society, and they have come through the court system. And I have funded, as I said, over 2 million euro, 2.8 million euro, to fund 30 additional staff to open the first 10 beds. It's not one staff per bed at here, like. You know, these are really, really dedicated staff. We already have two PICUs, which are two psychiatric intensive care units open across the country. But I think what we must remember as well, that the National Forensic Mental Health Service, it's not only there for prisoners or those who come through the court system. I also have people living in this country that have endured mental health conditions, and there might come a time, about 10% of those patients in the National Forensic Mental Health Services, because they are patients, they're not prisoners. They're detained patients. But we have to remember that, and this is where the crossover has not been acknowledged, that this is a hospital. The second point I'm making is that there are some people who have endured mental health conditions who might have been institutionalised 30, 40 years ago, and at this stage, they might need that forensic mental health support. That's the other point. And I have to make sure there's a pathway for them as well. But I also want to touch on the 10 beds that were designed at the time for a forensic CAMHS unit, and we're not seeing the demand for that at all. So there wasn't 170 beds per se that were going to be provided just for people who come through the prison service. So we had CAMHS beds for forensic, we had the ICRU, and we also have people with enduring mental health conditions who have to come through the system. But there will be an additional capacity provided this year. There will be an additional 26 beds provided, which will go a long way towards the waiting list. I've also provided funding for further in-reach into Limerick, which will bring 11 of the 12 hospitals, the 12 prisons receiving inpatient mental health supports. I don't want to see anybody on a waiting list, and we will work to do that. But if I had all the money in the world, I would not be able to find all the staff in the world to open those beds this year. But I will do it incrementally, like I do everything incrementally. But it's something that I have worked on. You know, it's amazing, actually, when you talk about the National Forensic Mental Health Services, because they do an extremely good job. They're very rarely in the media, and it's a difficult job they do, and I want to commend each and every one of them who do that.