I move: That Dáil Éireann: notes the report from the Mental Health Commission entitled "Acute Mental Healthcare in Hospital Emergency Departments in Ireland: A National Survey from the Office of the Inspector of Mental Health Services", which found that "international best practice… is not available in most emergency departments in Ireland"; further notes that: — more than 50,000 people in mental health crisis present annually to emergency departments; — hospital managers are reporting increased mental health demand in emergency care; — the Mental Health Commission has found substantial variation in the quality of emergency mental health services across the State, which is having a negative impact on access to care; — eight emergency departments do not have appropriate spaces for mental health crisis assessments; and — professionals and advocates in the mental health sector have sought urgent policy actions, including a better mental health crisis model in acute hospitals, increased investment in community-based alternatives, and examination of an increased role for smaller hospitals in mental health emergencies; considers that: — a fully realised network of mental health emergency rooms, Suicide Crisis Assessment Nurse services, crisis resolution teams and community supports are essential to delivering the vision set out in "Sharing the Vision – A Mental Health Policy for Everyone", and ensuring that every person in crisis receives timely care; — access to safe, specialised, emergency mental health care remains inadequate, leaving many in crisis without timely access to care; and — mental health crisis centres are under development by the English National Health Service to provide safe rapid access spaces for people experiencing a mental health emergency; recalls the commitment in the Government's mental health policy "Sharing the Vision – A Mental Health Policy for Everyone", to provide appropriate mental health emergency facilities in every hospital; and calls on the Government to: — require every Model 3 and Model 4 hospital to have a dedicated mental health emergency room, separate from chaotic emergency departments; — commission an expert review of the role of Model 2 hospitals in providing crisis mental health services, and invest in a network of specialist mental health crisis centres; — ensure every hospital has the appropriate complement of specialist professionals; — ringfence investment in mental health crisis assessment and intervention services, including community-based alternatives such as therapy services, late-night outreach spaces, crisis resolution teams, and community-based assessment, support, and treatment teams; and — develop an integrated crisis response pathway for children and young people experiencing a mental health crisis, including an improved child and youth liaison service, with emergency departments. This motion seeks to reshape the way emergency mental healthcare is delivered. It sets out a clear plan for a dedicated and clinically appropriate emergency mental health system because too often, people experiencing acute distress are brought into busy emergency departments that are simply not designed to meet their needs. The 2024 Mental Health Commission national survey on acute mental health care found that international best practice is not available in most emergency departments. That is not a marginal issue; it is a systemic failure and has very real consequences. Just this afternoon, I received a response to a parliamentary question that clearly states there has been an increase in presentation numbers with self-harm and suicide-related ideation attending emergency departments each year from 2021 onwards. The 50,000 people who present to emergency departments each year in mental health crisis deserve a service fit for purpose. Yet, the commission also found substantial variation in the quality of care available, with access depending more on geography than need. I want to make clear that this is not through any fault of the front-line workers who work continuously doing extraordinary work, often under immense pressure. Eight emergency departments do not have an appropriate space to conduct an assessment, resulting in people in distress being assessed in corridors or other unsuitable areas. This is both unfair to the person in crisis and also to the staff member. We would not tolerate this for physical health emergencies and we should not tolerate it for mental health emergencies. This motion sets out a clear alternative, where every model 3 and 4 hospital has a dedicated mental health emergency room separate from the general emergency department. However, this is not only about our larger hospitals. Model 2 hospitals can support crisis care and that role must be examined and a network of specialist mental health crisis centres established, with ring-fenced investment in crisis teams and community alternatives. Children and young people are particularly exposed. Child and adolescent mental health services, CAMHS, are chronically under-resourced and limited out-of-hours provision means young people in crisis are often left without support or are brought to an unsuitable emergency department. At the end of November 2025, over 4,300 young people were on a CAMHS waiting list, with more than 1,000 waiting longer than a year. In crisis situations, these delays are dangerous. Ultimately, this is about parity of esteem. Mental health emergencies must be treated with the same urgency as physical emergencies. By investing in dedicated facilities, strengthening community alternatives, proper staffing and ring-fenced funding, a fully fit-for-purpose acute mental health care system in emergency departments can be delivered.

Sentiment score: -0.19

I welcome that the Government is not opposing the motion but the Minister of State and her colleagues need to act, and act much more quickly than they have to date. At the current rate it will be the mid-2030s by the time we reach the target under Sláintecare. People in crisis cannot wait that long. We are going to lose people. People are going to lose quality of life between now and then. I have heard the lack of service provision being described as "gaps" throughout this debate but these are not gaps but black holes of absolute service deprivation. In some areas services simply do not exist. A "gap" gives an indication this is something that is easily fixed but it is not as there is nothing there to link up in some areas and it is grossly unfair. We cannot keep sending people to emergency departments and calling that care because it is not. Those people should never be in emergency departments and would not need to be there if the proper structures were in place in the community, if we had suicide crisis assessment nurses and ring-fenced investment and if we as a State examined every possible potential specialist and activated each and every one of them, from our community therapists to our psychologists, our psychiatrists and our wonderful staff who are already in the mental health services. Each and every one of them needs to be activated. The Minister of State, Deputy Butler, spoke earlier about the suicide rates and four in five suicides being men. I do not believe in pitting one area of need against another. I do not believe in pitting one geographic area against another. However, when we speak of suicide and of mental health there is a group of people we do not recognise enough and they are the people who make the badges. It is the people who are not charities, are not NGOs and are not linked in formally with any structure of the State. I am going to be parochial here, which I very rarely do in the House, but I want to acknowledge on the issue of men's mental health Blue Balls Ireland, Blue Balls Midlands, Blue Balls Bull Wall and the newly-formed Blue Balls Wicklow. They do tremendous work and they are community-driven and grassroots-led. One thing has been very clear across every contribution this evening, which is that the current system is not working, that it is failing people in need and that it is failing the people who work in the services as well. I ask the Minister of State to act on this motion rather than just not opposing it.

Sentiment score: -0.25