Dáil Éireann debate -
Wednesday, 4 Apr 2001

Vol. 534 No. 1

Written Answers. - Mental Health Services.

Dan Neville

Question:

87 Mr. Neville asked the Minister for Health and Children the plans he has to address the practice of discharging those treated for mental illness who are homeless back on to the streets; if he will provide hostel accommodation for a period for homeless patients discharged from mental institutions; and if he will make a statement on the matter. [9888/01]

Minister for Health and Children (Mr. Martin)

I am aware that the homeless are a high risk group in relation to a number of health conditions, including mental illness. Current mental health policy, including the provision of care to the homeless mentally ill, is based on the recommendations contained in the report Planning for the Future which was published in 1984. The report recommended that psychiatric care should be primarily community oriented. Successive Governments have pursued this policy and the move from an institutional to a community-based setting has resulted in many improvements in our mental health services. New mental health centres, day hospitals and other day facilities have been set up and at the same time additional community-based residential accommodation has also been made available. The number of hostels for the mentally ill in 1983 stood at 111 providing 942 places, increasing to 398 in 1999 and providing 2,923 places.

In implementing Planning for the Future many patients were given rehabilitation and social skills training to enable them to live independently in the community and health boards provided hostels or community residences to people moving out of psychiatric facilities. While it is acknowledged that those leaving residential care may be at risk of becoming homeless, research undertaken on former long-stay patients of St. Brendan's Hospital shows that virtually no former long-stay patients have become homeless. On the contrary, it is seen to be more likely that the problem lies with new patients presenting to smaller psychiatric units based in general hospitals for psychiatric disorders which are but one component of substantial social disorganisation. This is often complicated further by alcohol and drug abuse.

The Inspector of Mental Hospitals has issued guidelines setting out the discharge policies and procedures which should be in place in each hospital and acute psychiatric unit. A clear discharge plan should be designed for each patient, to ensure that all appropriate information is given and all appropriate services arranged prior to the patient's actual discharge. This includes checking to ensure that the patient has suitable accommodation.

Officials of my Department are presently working on the preparation of a strategy designed to prevent homelessness. The objective of this preventive strategy is to provide guidance to health boards to ensure procedures and policies are in place to reduce the risk of people leaving institutional care becoming homeless. This preventive strategy includes arrangements for people leaving psychiatric facilities.