Amnesty International's recently published report, "Mental Illness: The Neglected Quarter", highlights areas of genuine concern in relation to mental health services. These are concerns which the Government shares and which it intends to address. To its credit, Amnesty International's report acknowledges the substantial progress that has been made in recent years in improving the mental health services.
In the period 1999-2002, an additional €70.7 million revenue funding was invested in the mental health services. In the current year, additional revenue funding of €7.6 million will be provided for ongoing developments in mental health services, including the areas of child and adolescent psychiatry, psychiatry of later life, liaison psychiatry, suicide prevention initiatives and support for the voluntary sector for the development of advocacy services in Ireland. Overall, about €190 million in capital funding is being provided through the national development plan to facilitate the development of acute psychiatric units attached to general hospitals, as a replacement of services previously provided in psychiatric hospitals. The latest of these, at St. Luke's Hospital, Kilkenny, opened its doors to patients yesterday, 5 March.
There are now 15 general hospital psychiatric units operational throughout the country. A further two units will become available in the near future, two more are under construction and several others are at various stages of planning. There are now approximately 400 community psychiatric residences in the country, providing over 3,000 places. This compares to 111 residences providing less than 1,000 places in 1984. As for day hospitals-day centres, there are approximately 2,000 providing over 3,500 places, compared with 39 such centres providing approximately 1,200 places in 1984.
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I agree with Amnesty International's views on the importance of providing advocacy services for people suffering from mental illness. The Government made clear its support for the development of advocacy services in Ireland by its commitment, contained in the Programme for Prosperity and Fairness, to assist initiatives to provide independent advocacy services for people who are involuntarily detained under the provisions of the new Mental Health Act 2001. In a concrete expression of the Government's commitment in the health strategy to develop advocacy services in mental health, €251,000 was provided by my Department to health boards and voluntary agencies for this purpose in 2002. An additional €50,000 has been provided for 2003.
In relation to mental health services for children and adolescents, services for this age group still require substantial development. However, we have already come a long way. In 1997, there were few child and adolescent psychiatric services available outside the major cities. Now each health board has approval and funding for a minimum of three consultant led, multidisciplinary child and adolescent psychiatric teams. In 2002, additional revenue funding of €6.061 million was allocated to provide for the appointment of additional consultants, for the enhancement of existing consultant led multidisciplinary teams and towards the establishment of further teams. A further €1.64 million was allocated in 2003.
The development of child and adolescent psychiatric services has been a priority in recent years. The first report of the working group on child and adolescent psychiatric services, which was presented to the Minister on 1 March 2001, contained recommendations for the development of seven child and adolescent psychiatric in-patient units. Project teams have now been established in respect of proposed units in Cork, Limerick, Galway and one in the Eastern Regional Health Authority area, at St. Vincent's Hospital, Fairview.
The health strategy "Quality and Fairness – A Health System for You", contains a commitment to prepare a new national policy framework for the further modernisation of the mental health services. The mental health services have not been reviewed in a systematic way for almost 20 years and the need for such a review is one of the key recommendations of the Amnesty International report. I expect work on the new policy framework to begin in the coming months.
The Mental Health Act 2001 represented the first significant reform of mental health legislation in this country for over 50 years. Its purpose was to update legislation concerning the involuntary detention of persons for psychiatric care and treatment and to establish mechanisms by which the standards of care and treatment provided in the mental health services would be supervised and regulated. When fully implemented, the Mental Health Act 2001 will bring Irish mental health law fully into conformity with the European Convention on Human Rights and into line with best practice in the field internationally.
The Act contains many positive provisions which improve the rights of patients. These provisions have been warmly welcomed by Amnesty International in its report. In the report, the organisation notes that the Act expressly provides for the right to information about the circumstances of a detention and any proposed treatments. It also provides that patients must be informed of their right to a review of their detention, their right to legal representation and to legal aid where appropriate.
The main vehicle for the implementation of the Mental Health Act 2001 will be the Mental Health Commission. The commission's primary function is to promote and foster high standards and good practices in the delivery of mental health services and to ensure that the interests of detained persons are protected. The establishment of the commission in April 2002 is also welcomed by Amnesty International in its report.
