List of recommended actionsto be undertaken by the department of health and the hse as appropriate

Engagement with the Department of Health
Action 1: Furnish the Joint Committee with the detailed report that has been completed by the Oversight Body which maps current service provision against A Vision For Change’s aspirations without delay [Paragraph 3].
Action 2: The stakeholder consultation planned for next month by the Oversight Body should not proceed until there has been meaningful engagement with the oversight body and with the Joint Committee [Paragraph 5].

Primary Care
Action 3: Develop a realistic plan and timeframe for the provision of 24/7 crisis intervention teams nationally [Paragraphs 45, 70and 116].
Action 4: Develop a national plan specifically to address capacity in primary care CAMHS services [Paragraph 46].
Action 5: Formulate an action plan to address the lack of cohesion between primary care and mental health services [Paragraphs 16, 36, 50].
Action 6: Outline referral pathways for mental health service users in primary, secondary and tertiary care and to include those presenting with a dual diagnosis [Paragraph 51].
Action 7: Clearly signpost the services that are available in the community, both to health practitioners and service users [Paragraph 51].
Action: 8: Reduce the over-reliance on the prescribing of medication by increasing investment in counselling and talk therapies [Paragraphs 35, 53].
Action 9: Assess whether more e-Mental Health services could be offered, and include mental health as a distinct area of work in the e-Health Strategy [Paragraph 58].
Action 10: Roll out an efficient IT infrastructure across the health service with an emphasis on mental health to include a directory of services/managers, e-referrals/appointments and virtual clinics [Paragraph 37].

Recruitment
Action 11: Mainstream mental health training across all health disciplines, including in maternity and neo-natal care [Paragraph 94].
Action 12: Assess the prevalence of practical obstacles to continuous professional development and develop an action plan to minimise these [Paragraphs 83, 97].
Action 13: Urgently and realistically assess whether pay in the health sector is sufficient to attract and retain clinical staff, taking account of the findings of the 8
Public Service Pay Commission which is due to report on the issue in June. Revisit the Haddington Road Agreement regarding the requirement for clinical staff to work one day per month free gratis. [Paragraphs 74, 81, 99, 103, 124].
Action 14: Provide special subsidised accommodation for health sector staff to alleviate the cost-of-living burden [Paragraphs 79, 104, 105]
Action 15: Promote the use of flexible work patterns to retain workers [Paragraph 106].
Action 16: Promote the positive aspects of working in the mental health sector and the meaningfulness of such a career to young people considering career options, in venues such as schools [Paragraph 106].
Action 17: Amend the Medical Practitioners Act 2007 to allow doctors from other jurisdictions to take up training posts in Ireland [Paragraph 75, 101].
Action 18: The recruitment process needs to be reviewed particularly regarding recruitment being carried out on a national level and lack of backfill for upcoming vacancies [Paragraph 76, 91, 102].
Funding:
Action 19: Prioritise the development of an IT system which will enable efficient sub-speciality expenditure reporting. Until such a system is a available, prioritise manual sub-speciality expenditure reporting across the nine CHOs [Paragraphs 107, 108, 109, 110].
Action 20: Increase the proportion of the Health budget allocated to mental health services to the level seen before de-institutionalisation in order to realistically allow for the implementation of A Vision for Change [Paragraphs 112 – 115].
Action 21: Increase the proportion of Health development funding which is spent on mental health and ensure development funding is used in a targeted manner to redress geographical imbalances in spending and service provision [Paragraph 123].

Mental Health Services for People from Minority Groups:
Action 22: Support and fund Traveller specific services, especially Traveller health services which are led and staffed by Travellers [Paragraphs 127 - 139].
Action 23: Create an ethnic identifier for Travellers which can be used to assess health outcomes [Paragraph 130].
Action 24: Ensure training for all health workers so that they are aware of specific issues for and needs of Travellers, LGBTI people and migrants [Paragraphs 125, 128, 133, 136]
Action 25: Establish a specialist health unit for transgender people which would remove the unnecessary reliance on services like CAMHS for gender dysphoria diagnosis [Paragraph 133].
Action 26: Consider removing the need for parental consent for under 18s to access mental health services [Paragraph 134].
Action 27: Integrate mental health supports into the health programme for victims of human trafficking in Ireland [Paragraph 137].
Performance Indicators:
Action 28: Assess the current suite of mental health KPIs, with a view to expanding them so they measure health outcomes as well as weekly/monthly activity [Paragraphs 140, 141, 143]
Action 29: Incorporate patient feedback and quality of care into KPIs [Paragraph 143, 144]
Action 30: Expand data collection to include patient experience outside of in-patient units [Paragraph 142].
Action 31: Assess the feasibility of the development of Electronic Health Records [Paragraph 146].