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Dáil Éireann debate -
Thursday, 25 Oct 2001

Vol. 543 No. 1

Other Questions. - Mental Hospitals Report.

Deirdre Clune

Question:

6 Ms Clune asked the Minister for Health and Children the steps he has taken to meet the concerns expressed by the Inspector of Mental Hospitals in his report for the year ending 31 December 2000. [25518/01]

I welcome the publication of the report of the Inspector of Mental Hospitals for 2000 and acknowledge the important role the inspector plays in providing an accurate and detailed account of services in the mental health sector throughout the country.

In his latest report, the inspector highlights a number of areas within the mental health services which require attention. These include the extension and enhancement of multi-disciplinary teams, the provision of additional community-based residential accommodation and other community-based facilities such as day hospitals and day centres, and the further development of specialised psychiatric services for care groups, such as children and older people. It is my intention to facilitate health boards in bringing about the necessary improvements and developments identified by the inspector in his report. Capital funding of approximately £150 million is being provided for the further development of mental health services over the lifetime of the national development plan. This funding will go towards the further development of acute psychiatric units attached to general hospitals and the enhancement of community based residences and facilities.

Additional revenue funding of £18.64 million has been provided this year for improvements in mental health services. Priority is being given to the further development of community based mental health services, the further expansion of child and adolescent psychiatry and the psychiatry of old age and the implementation of the recommendations of the task force on suicide. Provision has also been made for additional funding to voluntary bodies representing the interests of the users of the mental health services and their families and carers.

The inspector also referred in his report to further progress on the Mental Health Bill. The new Mental Health Act was signed by the President on 8 July 2001 and provides for the independent and automatic review of each decision to detain a patient for psychiatric care and treatment and puts in place mechanisms by which the standards of care and treatment provided in psychiatric in-patient facilities can be supervised and regulated. A Mental Health Commission is to be set up to act as an independent agency to raise standards and practices in the delivery of mental health services and to ensure that the rights of detained persons are protected. I hope to appoint the members of the commission within the next few months.

In his report for 2000, the Inspector of Mental Hospitals notes the continuing decline in the number of patients in psychiatric inpatient facilities, from 4,768 at the end of 1999 to 4,559 at the end of 2000. There were more than 24,000 admissions to these facilities in 2000 of which approximately 6,750 were first admissions. The proportion of patients being admitted to acute psychiatric units in general hospitals continued to increase and, in 2000, accounted for 43% of admissions. A further 13% were admitted to private hospitals. The number of involuntary admissions at approximately 2,450 remained constant at 10%.

I hope when the Minister appoints the members of the Mental Health Commission he will not repeat what he did with the Blood Transfusion Service Board.

Is the Minister aware that on 28 September the Director of Schizophrenia Ireland, in a statement about the serious failings in mental health care provision, said:

It is intolerable that, year after year, we must read of serious quality failings, lack of true multi-disciplinary teams and wasteful service provision. Much of the content of the inspector's report remains unchanged from previous years. It is unacceptable that the Inspector of Mental Hospitals is obliged to repeat, each year, the consistent inadequacies in the psychiatric services.

Could there be any more damning comment by an independent observer than those comments by the Director of Schizophrenia Ireland?

The Deputy has exceeded the time allowed, which is only one minute for a supplementary.

The comments and references in previous reports of the inspector are a damning indictment of Irish society and of successive Irish Governments over the past 30 years. Over the past four years, and this is a tribute to my predecessor and the budget for last year, there has been a dramatic increase in investment and a clear policy direction in terms of moving towards community based facilities. The inspector draws attention to the progress which has been made and in my subsequent meeting with him to discuss the report he said that steady progress had been made. I acknowledge that in some areas it has been slow, but we are making significant improvements in certain areas particularly in moving the new acute psychiatric units attached to general hospitals. We have made significant progress in community based facilities but much more needs to be done in that area. We have made significant progress on multi-disciplinary teams but have much more to do. Perhaps the most significant constraint in this regard is our ability to attract sufficient health professionals including psychologists, psychotherapists, social workers, physiotherapists, occupational therapists, etc.

Is the Minister aware of a Fine Gael proposal to provide £10 million to lead Europe in mental health research? Would he consider that would be a project worthy of being pursued, particularly in view of the fact that from 1997 to June 2001, the Government has spent in excess of £10 million on public relations?

I have not read the proposal, but we have recently produced a fairly exciting document on health research strategy. This envisages an enhanced role for the Health Research Board in terms of funding research projects which would have international peer review. Any significant research projects for mental health should be progressed in that context. In the health boards, we need a stronger research culture than we have had in the past.

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