Dáil Éireann Debate, Tuesday - 10 October 2023
460. Deputy Fergus O'Dowd asked the Minister for Health if, further to the Government commitment to develop an action plan to combat loneliness in the programme for Government, the Roadmap for Social Inclusion and the Healthy Ireland Strategic Plan, he will identify the unit in his Department that has responsibility for developing this plan; when the plan will be published; and if he will make a statement on the matter. [43479/23]
View answerEvidence shows loneliness is a significant issue for population health and a number of different studies have linked loneliness to multiple chronic health conditions. Loneliness levels in Ireland are rising, and the pandemic was a major contributory factor to increases in social isolation. Loneliness can be detrimental for our physical and mental health, while reconnecting with others post-COVID-19 pandemic has numerous physical and mental health benefits.
The 2021 Healthy Ireland Survey which was carried out while significant restrictions were still in place, found a significant increase in isolation and a decrease in the proportion of the population reporting positive mental health. Some 81% reported lower levels of social connectedness and 30% reported worsening mental health since the pandemic started.
Given the detrimental impacts of loneliness, a significant body of work has been undertaken, across diverse areas of the Department of Health and the HSE, to address this.
In response to the increase in loneliness which particularly impacts older people, the Ministers for Health and the Chief Medical Officer, supported by Healthy Ireland, developed a nationwide campaign, aimed at older people to encourage them to rebuild their social connections and re-integrate into their communities. Post-pandemic, with vaccines and sensible precautions, it is safe for older people to reconnect with the world, to say “Hello Again World”, make up for lost time and re-establish important connections with their community.
Social prescribing recognises that health is heavily determined by social factors such as poverty, isolation and loneliness, offering GPs and other health professionals a means of referring people to a range of non-clinical community supports which can have significant benefits for their overall health and wellbeing. HSE-funded Social Prescribing services are now available in 44 locations across the country. These services are delivered in partnership with community and voluntary organisations such as Family Resource Centres and Local Development Companies, and as part of the Sláintecare Healthy Communities Programme.
Mental health of older people is a priority in Sharing the Vision, Ireland's national mental health policy, with actions including improving access to Mental Health Services for Older People, promoting evidence-based digital mental health interventions in the general population and with older persons, and linking recommendations with the National Positive Ageing Strategy.
To this end, the Age Friendly Homes Programme began in 2021 as a two-year pilot project, with the overall objectives to prevent early or premature admission to long-term residential care; enable older people to continue living in their homes or in a home more suited to their needs; help older people to live with a sense of independence and autonomy and support older people to be and feel part of their communities. Funding of €5.2 million has been allocated in Budget 2023 to roll-out the Healthy Age Friendly Homes Programme nationally in 2023.
The HSE, in conjunction with ALONE, is also continuing the roll out of a Support Coordination Service across the country. This service supports older people to live well at home independently, and for as long as possible, through support coordination and access to services such as, but not limited to; practical supports, befriending, social prescribing, assistive technology, and coordinated linkages to local community groups in their area. This service is being led out under the Enhanced Community Care (ECC) Programme, a strategic reform programme in line with Sláintecare proposals and priorities which seeks to deliver new and enhanced services and support the move toward a more community-centric model of healthcare.
As part of the ECC programme, the Integrated Care Programme for Older Persons (ICPOP) model aims to shift the delivery of care for older people away from acute hospitals towards a community based, planned and coordinated care model which is closely aligned to Primary Care and Acute sector partners. The objective of the programme is to improve the quality of life for older people by providing access to integrated care and support that is planned around their needs and choices. This supports them to live well in their own homes and communities without the need to access acute care settings. As of Quarter 2 2023, 23 ICPOP teams have been established across Ireland, with 30 expected to be established in total by year end.
The HSE have advised that in line with the Enhanced Community Care Programme (ECC), their objective is to deliver increased levels of health care with service delivery reoriented towards general practice, primary care and community-based services. The focus is on implementing an end-to-end care pathway that will care for people at home and over time prevent referrals and admissions to acute hospitals where it is safe and appropriate to do so and enable a “home first” approach.
The ECC Programme was allocated €240m for the establishment of 96 CHNs, 30 Community Specialist Teams for Older People, 30 Community Specialist Teams for Chronic Disease, national coverage for community intervention teams and the development of a volunteer-type model for CHN’s in collaboration with Alone.
An integral component to maintaining people well at home and in their community is collaboration with the ALONE Organisation and there is now full national coverage of the ALONE across the nine Community Healthcare Organisations.
1. The HSE works in collaboration with ALONE, an organisation that offer a volunteer type model to support CHN’s. Specifically in relation to older people in the Community, including those who are lonely, isolated, frail or ill, homeless, living in poverty, or are facing other difficulties services are being developed in conjunction with ALONE.
2. ALONE assists older people with a suite of tailored supports such as practical supports, befriending, phone services, social prescribing and assistive technology to improve physical, emotional and mental wellbeing to enable older people live independently with an improved quality of life (over 24, 791 older people have been supported directly through Alone services from January – June 2023).
3. ALONE provides a point of contact for older persons to assist in navigating and accessing a wide range of services including health, social care, and government services both local and national, and in areas provide support to Specialist Teams for Older Persons within the hospital setting.
4. ALONE received over 8585 referrals (Jan to June 2023) from a variety of sources such as Hospitals, Primary Care teams, community sources, self-referrals, referrals from family and members of the public.
5. ALONE provided 18,000 new interventions this year supporting older people who have difficulties in areas such as housing, isolation and loneliness, finance and legal, physical health, mental health, personal care, technology, safety and security etc.
The HSE continues to engage and work with ALONE, who are reaching a large cohort of older people through their services and helping them live healthy lives at home and addressing such issues as loneliness and isolation. This is playing an important role in ensuring appropriate use of primary care and hospital services across Ireland.
The Government is committed to ensuring that those living with dementia have access to the right services and supports to help them to live well in their communities and have invested €12.16 in dementia services and supports in 2023: €4.86 million has been provided for the National Dementia Strategy and €2.1 million for the full resumption of dementia-specific day care services. The Government have also prioritized investment valued at €5.2 million to allocate a minimum of 15% of 5 million new home support hours to people with dementia, up from 5% in 2021 and 11% in 2022. This investment is in addition to €5.9 million provided for the implementation of the National Dementia Strategy in 2021, and a further €7.3 million in 2022.
Acknowledging the disproportionately negative impact of the pandemic on older persons, the Programme for Government (2020) commits to the establishment of a commission on care that will ‘assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens’, learning the lessons from COVID 19. In 2022 preliminary research was undertaken within the Department of Health in preparation for the establishment of the commission on care, the scoping and planning for which are being further advanced as a priority in 2023.
At a local level, Mental Health Day Services provided by the HSE are available to those who may require them, which provide mental health and medication supports, as well as wider assistances associated with daily living. In addition, in May this year an additional €5.25 million funding was announced for meals on wheels and day centres for older people to organisations across the country.
The Roadmap for Social Inclusion 2020 - 2025: Ambition, Goals and Commitments was published in January 2020. The primary ambition of the Roadmap was to “Reduce consistent poverty to 2% or less and to make Ireland one of the most socially inclusive countries in the EU.
At the end of 2022, 39 of Roadmap commitments were either fully achieved or achieved with ongoing delivery, with a further 4 commitments in progress on schedule with ongoing delivery, and delivery on 26 commitments in progress.
The Roadmap for Social Inclusion is an overarching statement of Government strategy, which acknowledges the range of sectoral plans already in place that have social inclusion as a core objective, in areas such as education, health, children and childcare, community development and housing. These plans remain key to ensuring that social inclusion is at the core of public policy and service strategy across all government departments and services.
While the action plan to combat loneliness has not yet been specifically resourced within the Department, as outlined above, the issue of loneliness is being addressed through a significant number of different workstreams and initiatives.
