7. Deputy Mark Ward asked the Minister for Health if he can guarantee when inpatient residential dual diagnosis services will resume in a treatment centre, details supplied; the reason for the delay in reopening these services; and if he will make a statement on the matter. [39162/24]

Deputy Mark Ward: Will the Minister confirm that the inpatient dual diagnosis service will resume at the Keltoi treatment centre in St. Mary's Hospital, Phoenix Park? When will the residential service reopen?

Deputy Mary Butler: I acknowledge the Deputy's continued interest in this matter. The model of care in regard to dual diagnosis was launched only last year. In 2021, I launched the model of care for attention deficit hyperactivity disorder, ADHD, for adults, with four new teams in place this year. We will continue to complete that roll-out. Given the model of care for dual diagnosis was launched only last year, we have a way to go.

The model of care describes a clinical pathway based on integrated service delivery across primary care, substance misuse, community mental health services and acute services. It recommends the development of 12 adult specialist dual diagnosis teams nationally and four adolescent teams. A total of €2 million has been provided for the service to date, with recruitment for adult teams in the mid-west and Cork and adolescent teams in Dublin at an advanced stage. I have allocated a further €600,000 in budget 2025 to enhance teams and establish a further two teams. This will include the appointment of: two whole-time equivalent appointments for community healthcare organisation, CHO, 3, which will enhance the existing team; one whole-time equivalent for CHO 9, which is the substance abuse service specific to youth, SASSY, team; one whole-time equivalent for CHO 4 for Cork Prison, which will be a new and really important team; three whole-time equivalents for CHO 7, which is an adolescent team, specifically, the youth drug and alcohol service, YoDA, team; and three whole-time equivalents for CHO 5 for a new team in Waterford. This was all done based on the heat map specifying the areas that did not have services.

The Department remains committed to developing the national dual diagnosis centre at the Keltoi facility, as envisaged under the model of care. The HSE is currently looking at staff requirements and other key dependencies for the development of the service. It has indicated that a resource proposal will be submitted when the work is complete. That was not yet available when the Estimates were being done. We are working closely with the HSE. Dual diagnosis involves a complicated model. Some of the funding is provided from the drugs budget and some from the mental health budget.

Deputy Mark Ward: I have been working on this issue since the service closed during the Covid crisis in 2020. We were told at the time by the now Taoiseach and then Minister for Health, Simon Harris, that it would be open as soon as the Covid crisis finished. I raised the matter again with the former Minister of State, Deputy Feighan, and the Minister of State, Deputy Naughton. I expected the Minister of State, Deputy Burke, to take this question today. Will the Minister of State, Deputy Butler, indicate who has responsibility for the Keltoi centre? Under which Department does it fall? When more than one Department has responsibility for something, it can fall through the cracks. The Keltoi centre plays a really vital role. As with eating disorders, which we have talked about, it is important to have an inpatient facility where people can go to get out of society for a while and access the specialist help they need. I support the model of care the Minister of State has been talking about but we need that residential provision. When will the service reopen?

Deputy Mary Butler: I do not disagree with the Deputy. The Keltoi rehabilitation centre is hugely important. It is recommended in the model of care that the centre provide a dual diagnosis service. It is intended to be used for rehabilitation of those with serious and significant mental health difficulties and substance use disorders. It will accept referrals from across Ireland, which is really important. Access will not be limited by a postcode lottery. The service is planned as a partnership between the HSE and social inclusion in CHO 9. It will offer a dual diagnosis national clinical programme. I envisage the mental health funding certainly will come from the mental health budget of my Department. We are very much engaged in the process and have had meetings recently. Some funding will also come from social inclusion. It is something I want to see progress very quickly. The fact the inpatient rehabilitation centre will serve the whole country is hugely important.

Deputy Mark Ward: Keltoi is a facility I know very well from my professional life before I came to this House. I know the important role it plays. I am still concerned about the funding coming from different Departments and the question of who is responsible. Where does the buck stop when it comes to reopening the residential service? The centre is back open as a day facility but the residential service is missing. In the reply to a parliamentary question of mine in April, I was told a capital submission for the project had been approved. That was welcome. Unfortunately, no funding for the project was allocated in 2024. Is funding allocated for it in 2025? It is vital that the service is reopened as soon as possible.

Deputy Mary Butler: As the Deputy said, the day service is open. My understanding is that the submission we received was not sufficient at the time to enhance the residential element of the service. That is still being worked on, as I said, between social inclusion, the HSE and the Department of Health. I expect the mental health unit within the Department to take the lead on this. We are driving it on. That is where it should sit. We are working in partnership with social inclusion and with CHO 9. I am delighted that there will be €1.3 million in recurring funding for dual diagnosis. Ten posts will be filled this year. A dual diagnosis team is not like an eating disorders team. It does not need as many posts and the teams can be set up much more quickly. Having the ten whole-time equivalents in place certainly will enhance what we have. We are keeping a really close eye on the Keltoi service because it is an area on which we want to see progress. We have a premises and co-operation from all the different services and stakeholders. We will move on it as soon as we are ready to do so.

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Dáil Éireann debate. Question 27 - Mental health services [39430/24]

27. Deputy Violet-Anne Wynne asked the Minister for Health the progress made by his Department in respect of the status of the mental health de-escalation unit and the dual diagnosis programme for the mid-west; and if he will make a statement on the matter. [39430/24]

Minister of State at the Department of Health: The pilot project Community Access Support Team (CAST), to be trialed in the Limerick Garda Division, is to be launched next week October 7th, with the team expected to become fully operational shortly thereafter.

It is not a de-escalation unit per se, but instead is a partnership project between An Garda Síochána and the HSE and involves a team based approach to supporting vulnerable people presenting with mental health difficulties and situational trauma.

It will complement the work of our National Clinical Programme on Dual Diagnosis,, which will develop services to people who experiences both a substance abuse problem and a mental health issue, with treatment options to address both.

The Model of Care, which I launched last year with Minister Naughton, describes a clear clinical pathway of integrated service delivery across primary care, substance misuse, community mental health and acute services, through the development of 12 Adult Specialist Dual Diagnosis Teams nationally, and 4 Adolescent Teams.

To date, funding of over €2 million has been provided to support recruitment in this area, and in Budget 2025 I have allocated €600,000 for an additional 10 WTEs.

Recruitment for the two adult teams in the Midwest and County Cork is ongoing and the teams are not yet accepting referrals, and recruitment for the two adolescent teams in the Dublin area are also at an advanced stage.

Individuals who require treatment for dual diagnosis are currently being supported by the relevant HSE social inclusion addiction services in their community.