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Seanad Éireann · 2026-02-25

Mental Health Services

FF Mary Butler · Waterford · Minister of State at the Department of Health

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Summary of this debate

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Demand for forensic mental health services has grown significantly in recent years, including increased need for inpatient beds at the Central Mental Hospital in Portrane. The 170-bed complex includes a 130-bed Central Mental Hospital, a 30-bed intensive care rehabilitation unit, ICRU, and a ten-bed forensic child and adolescent mental health services, CAMHS, unit. There are currently 114 operational beds at the Central Mental Hospital, a 20% increase on the former Dundrum hospital.

Two beds opened in December and other beds will open in the next few weeks. When the ICRU beds open later this year, the campus will operate 140 beds, an increase of 45 beds and almost 47% more capacity compared with Dundrum.

Built by scoring every sentence in the debate on how distinctive its language is, then quoting the highest-scoring ones back word for word and in the order spoken. Nothing is paraphrased or invented — if a sentence appears here, it was said in the chamber. Drawn from 1,077 words across 4 contributions by 2 speakers.

Most used terms in this debate

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beds 35
mental 29
forensic 13
hospital 16
prison 10
icru 4
rté 9
health 18
portrane 5
psychiatric 6
open 14
investigates 5

The full debate

All 4 contributions, start to finish, in the order they were made. The one you came here for is highlighted.

IND Victor Boyhan

I welcome the Minister for State back to the Seanad. It is always good to see her. I thank her for coming here to deal with this Commencement matter, which falls within her remit and responsibilities.

I want to set the scene here because that is important. Ironically, I had tabled this Commencement matter yesterday but it was not selected. I am lad it was not selected because today I will be quoting from Judge Alan Mitchell. A posting by RTÉ at 12.10 p.m. yesterday was really interesting because it very much relates to the point I am going to make.

I said to the Minister of State I had watched the "RTÉ Investigates" programme from about two weeks ago entitled "The Psychiatric Care Scandal". It was broadcast over two nights. It was, to say in the least, very disturbing but very necessary viewing. 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. It showed the anguish of family members who fear for the well-being and, in many cases, the lives of their loved ones experiencing mental disorders and the health crisis around that. It showed people in the criminal justice system crying our for help that never came in many cases and families watching their loved one's physical and mental health dramatically deteriorate.

Conor Ryan of the "RTÉ Investigates" programme's retelling of the families' stories of grief and pain flowed through our screens and into our homes. It was really public broadcasting, maybe at its saddest, but at its best because it shone a light in a very dark place. It acted as another focus or advocate for the crisis we are referring to here today. I acknowledge Conor Ryan's professionalism with RTÉ's "Prime Time" and RTÉ itself for the amazing investigative programmes it has produced.

"RTÉ' Investigates" exposed what many families, clinicians and advocate organisations have been telling us for years. The State is relying on prisons to manage many people with severe mental illness. The State is failing to provide adequate and appropriate healthcare, despite our domestic and international human rights obligations, including the European Convention on Human Rights and the UN Convention on the Rights of Persons with Disabilities.

The RTÉ documentary highlighted people who had already been diagnosed with serious mental health conditions. Some were bipolar or 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 they clearly required. The HSE and the national forensic mental health service is clearly under-resourced and overwhelmed. I have spoken directly to some of the people involved here and this is what they tell me. The Minister and I both know and agree that prison is not a therapeutic place. It cannot address the trauma nor heal people who are unwell. Prison staff are not fully equipped 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.

The Government press release referred to a new change and a new direction, and one that we all welcomed. I understand that, as of yesterday, one third of the facility's beds are not opened. Some 50 beds remain empty while people remain in squalid prison conditions. I take this opportunity to thank Saoirse Brady, director of the Irish Penal Reform Trust.

There is a report on yesterday's RTÉ News website with the heading, "'No options' for psychiatric patients held in prison, judge warns". Referring to a case before Judge Alan Mitchell, the article states, "Solicitor for the HSE, Alan Doyle, told him that it was hoped 10 beds at the CMH would be opened by the end of March but that this had not been confirmed."

I am here to work collaboratively with the Minister of State and I know she is with me. My focus is on when we can get a timeframe, even a gradual timeframe, for these 50 beds to open.

FF Mary Butler this contribution

I begin by acknowledging the concerns raised in the recent "RTÉ Investigates" programme on forensic mental health services. While I am 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 involving the Central Mental Hospital. I have also asked that all appropriate care options for the individuals featured be examined. I 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, 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 Portrane. The HSE actively manages the admission waiting list and works closely with the Irish Prison Service to prioritise those with the most urgent clinical needs.

The first piece of legislation I moved at the end of 2020 was the legislation to support those living in the Central Mental Hospital in Dundrum to be transferred to Portrane. In 2022, I opened the new Central Mental Hospital at Portrane, transferring 93 patients from the old Dundrum facility. This state-of-the-art campus, one of the best, if not the best, of its kind in Europe, was delivered with €212 million in Government capital investment. The 170-bed complex includes a 130-bed Central Mental Hospital, a 30-bed intensive care rehabilitation unit, ICRU, and a ten-bed forensic child and adolescent mental health services, CAMHS, unit. It was always intended that the full capacity at Portrane would become operational on a phased basis because these are very dedicated specific staff.

There are currently 114 operational beds at the Central Mental Hospital, 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 the 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 and four for in-reach into prisons. These beds will open gradually over the coming weeks and months. 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 ten beds in the new ICRU. Bringing these beds into use will support smoother patient movement through the Portrane campus’s different levels of care, helping create space for further admissions. This year’s funding will bring the National Forensic Mental Health Service workforce to approximately 580 staff. When the ICRU beds open later this year, the campus will operate 140 beds, an increase of 45 beds and 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 at Carraig Mór in Cork and the Phoenix Centre in Dublin. While these provide short-term intensive care, ICRUs offer both intensive treatment and longer term rehabilitation.

IND Victor Boyhan

I thank the Minister of State for her comprehensive statement. The reality is that there are beds that have not been opened in the facility. Some 50 beds remain empty while people remain in squalid conditions in our prisons. I accept that a lot has been achieved and I would be the first to say that. The reality is that we need to have these 50 beds. We have budgeted for it and the taxpayers have paid. The beds are in place. It is really important that we prioritise. I hear the Minister of State's point about incremental increases. I would like us to be in a position to say at the end of the year that those 50 beds have been filled.

I draw the Minister of State's attention to this article, which I will send on to her office. She may or may not have seen it on yesterday's RTÉ News website with the headline, "'No options' for psychiatric patients held in prison, judge warns". He was sitting at Cloverhill District Court in the prison. He has said he will now have to look at alternatives. It is really important. The solicitor for the HSE, Alan Doyle, is on the record as saying that ten beds would open hopefully by the end of March but was not in a position to confirm that. Could we be ambitious and say that we will have 30 beds open this year? I am not asking the Minister of State to say that now because clearly she will have to think about it and talk to the people on the ground. However, we have the facility and we have the beds. They are there; let us open them. I have no doubt that those involved in the "RTÉ Investigates" programme will be following this story here today. There is a story and it is important that we be ambitious enough to fill the 50 beds that are in place in this facility.

FF Mary Butler

I do not think the Senator listened to my answer, to be fair. I am ambitious enough and I can give him the response because I am the person who secured the funding last year to hire 45 additional very specific staff to work in the national forensic hospital. It is not that these staff are sitting on unemployment lists all over the country; they are hard to get. That is the first point. We recruited 45 of them, including 41 to open 18 beds. We opened two beds in December and will open the other 16 on a gradual basis, which is ongoing at the moment. We should have those additional 16 beds opened by the end of March.

The beds in the intensive care rehabilitation unit are different kinds of beds and this has been lost in the whole debate. These are the sickest people in society and they have come through the courts system. I have provided €2.8 million to fund 30 additional staff to open the first ten beds. It is not one member of staff per bed. These are really dedicated staff. We already have two psychiatric intensive care units, PICUs, open in the country. The National Forensic Mental Health Service is not only there for prisoners or those who come through the court system. There are people living in this country with enduring mental health conditions and about 10% of those patients are in the National Forensic Mental Health Service because they are patients and not prisoners; they are detained patients. This crossover is not being acknowledged; this is a hospital. Some people with enduring mental health conditions might have been institutionalised 30 or 40 years ago and at this stage they might need that forensic mental health support. That is the other point. I have to make sure there is a pathway for them as well.

I also want to touch on the ten beds that were designed at the time for the forensic CAMHS unit and we are not seeing the demand for that at all. There were not 170 beds per se that were going to be provided just for people who come through the Prison Service. We have CAMHS, forensic, the ICRU and also people with enduring mental health conditions who have to come through the system. Additional capacity will be provided this year. An additional 26 beds will be provided, which will go a long way towards dealing with the waiting list. I have also provided funding for further in-reach in Limerick, which will see 11 of the 12 prisons receiving mental health supports.

I do not want to see anybody on a waiting list. We will work on that.

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. It is something I have worked on. It is amazing, when we talk about the National Forensic Mental Health Service, because it does an extremely good job. It is very rarely in the media and it is a difficult job it does. I commend each and every one of those who do this work.

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