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Dáil Éireann debate -
Tuesday, 14 Dec 1993

Vol. 437 No. 2

Written Answers. - Psychiatric Hospital Accommodation.

Ivor Callely

Question:

170 Mr. Callely asked the Minister for Health if he will give a breakdown of the number of long stay psychiatric hospital beds in each health board area in 1993; and a comparison figure for each of the years 1973 and 1983.

The number of long-stay psychiatric hospital beds in each health board area in 1973, 1983 and in 1993 is given in tabular form.

As the figures indicate, the years 1973 to 1993 represent a period of significant change in the delivery of psychiatric services in Ireland. The report of the study group on the development of the psychiatric services Planning for the Future which was published in 1984 noted that the psychiatric hospital had been the focal point of the psychiatric services in most parts of the country and that large numbers of patients resided permanently in these hospitals. It recommended a shift in the delivery of services for the mentally ill from an institutional to a community-based service.

Since the adoption of the report as Government policy in the mid-eighties, acute units in general hospitals, day hospitals, day centres and community hostels have been opened to replace services previously provided in psychiatric hospitals. There are currently 14 acute psychiatric units in general hospitals. In 1991 there were 2,288 places in community hostels and 2,500 day hospital and day centre places for the mentally ill. Such facilities hardly existed in 1973. Other therapeutic interventions which have altered the delivery of psychiatric services include domiciliary assessment, community nursing and home support, respite care, out-patient clinics and clinical rehabilitation services. Modern drugs have significantly reduced the length of time mentally ill patients have to spend in hospital and, consequently, the need for long-stay hospital beds.
At the same time, specialist services have been developed for persons who are maintained in psychiatric institutions but who were not mentally ill. These include persons with mental handicap, autism, the elderly and the homeless.
These developments have contributed to the reduction in the number of long-stay psychiatric hospital beds in each health board area and between 1984 and 1990 the rate of hospitalisation of psychiatric patients has decreased from 3.4 to 2.0 per thousand. However, it remains higher in this country than in Denmark, France, England and Wales.
Long-stay Psychiatric Beds in each Health Board Area

Health Board

1973

1983

1993

Eastern Health Board

N/A

2,439

1,242

Midland Health Board

1,380

957

349

Mid-Western Health Board

1,500

1,300

552

North-Eastern Health Board

862

510

280

North-Western Health Board

1,180

1,180

198

South-Eastern Health Board

1,940

1,559

777

Southern Health Board

2,327

1,887

1,154

Western Health Board

2,206

1,523

816

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