I thank Sinn Féin for this important and very timely motion on emergency mental health services. It is very timely because we are all acutely aware of the sheer level of demand that is there for mental health services and we know all too well of the lapses in timely care and the very devastating consequences when there are those lapses in care. Far too many are being failed by the lack of 24-7 care and the lack of appropriate space within our hospitals. It is unacceptable that assessments are taking place in inappropriate emergency department, ED, spaces that are not specifically designed for those with mental health issues. Broken bones, heart attacks and strokes are well set up within the emergency department and yet for mental health, which can be as serious with the potential for fatal consequences, it is very much the Cinderella of our health service in general but in particular within our EDs. We know there are 51,000 presentations to acute mental health services every year and the Mental Health Commission report on acute mental health and hospital EDs painted a very stark picture of an inconsistent service with inadequate assessment spaces. That in many EDs, patients are first cleared for medical issues before being assessed psychiatrically, is simply unacceptable. That practice has to end. I know we have asked the Minister of State these questions before. I know there are efforts being made. It is not happening in every ED but there are certainly EDs where it is happening. We know the lack of 24-hour mental health emergency care is having an impact. I know there was an announcement this year and we welcome that announcement but it is only 6 p.m. to 2 a.m. and that, to me, is not 24-7. I know the number of presentations after 2 a.m. may be very few but the reality is that if somebody at three or four o'clock in the morning is presenting with suicidal thoughts or whatever, that service is not there. The reality is that back in 2016, the Government promised to roll out 24-7 pathways and a decade on, we still do not have them. They are going to be introduced in a very limited way to 2 a.m. but, of course, it is only for the level 4 hospitals.

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That means there are significant gaps across the country so we need to see it for the model 3 hospitals also. It is great if it is going to happen next year. The other key issue I want to raise is in regard to the assertive outreach or on-street mental health teams. Again, it is a really important provision within the community. When we submitted parliamentary questions on this, the replies indicate that it seems there are huge gaps across the country. There are no assertive outreach or on-street mental health teams in Waterford, Wexford, Carlow, Kilkenny, south Tipperary, south Dublin, Wicklow, north County Dublin and the north and west of the city. That is simply unacceptable, particularly when we see the great work being done in Sligo-Leitrim, Cork and, with regard to Limerick, the community access support team within Limerick Garda station. There are models of care there that we need to see rolled out across the country. The last thing I want to say is that we all have not just stories but accounts from families of the devastating consequences of when there is not timely care. Maud Coffey was tragically killed by her partner in 2023. Her case speaks to the failings of emergency mental health care. Her partner had a mental health condition. He had presented looking for help. It was known that he had not been taking his medication for some months. He was suffering from a relapse of schizophrenia and he sought help from the team on the day he murdered Maud. He was given an appointment for the following week, despite it being known that he was not taking his medication for at least three months. Maud's family have been incredible in their fortitude in the midst of this incredible grief, to be able to speak out and talk about it being two lives that were destroyed three years ago and two families torn apart, and that it could have been avoided. Maud's family spoke so eloquently after the case concluded a number of weeks ago, where they talked about the systematic failings, both for Maud, who lost her life, and also for her former partner, who should have got some sort of attention on the day he went on to kill Maud. Our only hope is that after Maud's loss of life, her legacy should be that those interventions are there when people present. I know many of the rest of us in the Chamber know of other desperately sad cases. My plea to the Minister of State this evening is in regard to the 24-7 care. It should be 24-7 care and not part of that, and it should be for the model 3 hospitals as well. Second, with regard to the assertive outreach and on-street mental health teams, it is crucially important that we see that rolled out across the country. Critically, it is to prevent situations such as the killing of Maud and indeed other people who are at risk, such as families, friends, neighbours and other supports who are trying to help people through mental health crises. Their lives are at stake if the health system does not step up to the mark.

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