Dublin, April 2025 — Ireland’s Minister for Mental Health, Mary Butler, has issued a firm call for accelerated reform in emergency mental health services following the publication of a stark thematic review by the Mental Health Commission. The report, released by the Chief Inspector of Mental Health Services, highlights persistent shortcomings in how acute mental health crises are handled in hospital Emergency Departments (EDs) across the country.
In her official statement, Minister Butler welcomed the report’s findings, emphasizing the urgency of action. “My priority is that people in mental health crisis are provided with timely assessment and support in an appropriate environment that keeps them safe,” she stated.
The review echoes long-standing concerns raised by advocates and clinicians: busy hospital EDs, particularly outside of standard hours, are often unsuitable and distressing for those experiencing acute mental illness. The report notes that a significant number of patients in crisis leave before they are seen, deterred by the overwhelming environment and long wait times.
Minister Butler acknowledged the systemic issues driving these outcomes, stressing that “real alternative care pathways and therapeutic environments” must be expanded to ensure individuals in crisis are not left without appropriate support. Among the government’s ongoing initiatives are the development of Crisis Resolution Teams and the rollout of Crisis Cafés—community-based, out-of-hours services designed to offer immediate, non-clinical mental health support and early intervention.
However, Butler admitted dissatisfaction with the pace of change, saying she has “expressed [her] impatience to the HSE” and is pressing for an intensified rollout of alternatives to ED-based care. The Minister has directed her department to collaborate closely with the Health Service Executive (HSE) to prioritise implementation of the Commission’s recommendations—especially those concerning improved coordination between clinical teams, faster assessments, and expanded child and adolescent services during mental health emergencies.
The review underscores a broader national conversation about the suitability and safety of existing emergency care structures for vulnerable populations. It serves as a reminder that without timely, trauma-informed interventions, those in mental distress risk being further harmed by the very systems meant to protect them.
The Mental Health Commission’s full report is expected to inform strategic planning within both the Department of Health and the HSE as Ireland works to build a more compassionate, accessible, and effective crisis response system.
Minister for Mental Health Mary Butler Picture from X
