I welcome the Amnesty International report, Mental Illness, the Neglected Quarter, which was published last month and which promotes the rights of the one in four Irish people affected by mental illness. I will cite from the report. The report states that Amnesty International is concerned at the inattention paid by the Government of the Republic of Ireland to a series of national and international reports critical of its failure to fully respect the human rights of people with mental illness. It further states that ultimate responsibility for compliance with international law lies with the Government, not with individual Departments, health boards, civil servants or service providers.
The neglect down through the decades of the mental health services is one of the greatest disgraces of our society. The institutionalisation of the mental health services in Ireland has failed to live up to the World Health Organisation standards and there continues to be high admission rates to psychiatric hospitals, both voluntary and involuntary, due to the lack of community-based facilities.
I will make three references to the 2001 report of the Inspector of Mental Hospitals. The report states that the physical health examination of in-patients, as documented in in-patient records is often infrequent, desultory and superficial in nature. It recommends that the occurrence of sudden death of psychiatric in-patients due to asphyxia from inhalation of food and other materials should be investigated and taken care of and refers to suicides among psychiatric patients, which are not subject to any formal audit.
The Government is in breach of Article 20 of the UN Convention on the Rights of the Child by placing children and juvenile offenders in adult psychiatric facilities. This has been referred to repeatedly by the Inspector of Mental Hospitals and is now highlighted by Amnesty International as a breach of the UN Convention on the Rights of the Child.
The total expenditure on mental health services has dropped in the past 15 years from 12% to 7.2% of the overall health budget. That shows the inattention over the past 15 years. One in four people have a psychiatric illness at a certain stage of their lives but the expenditure has almost halved in relation to total health expenditure.
People with intellectual disabilities remain inappropriately accommodated in psychiatric institutions in violation of their human rights. We have repeatedly referred to this in this Chamber. As many as 18% of the child population under the age of 18 will experience significant mental health problems, yet services in Ireland for them are few, infrequent to access and there are long waiting lists. There is a lack of dedicated psychiatric services for adolescents, with most areas seriously short of adolescent psychiatric facilities, and some with none at all despite the fact that psychiatric disorders increase in prevalence in the adolescent years, with incidence of self-harm and suicide also increasing in those years.
There are few specialised mental health teams and outreach services dedicated to the rising number of homeless in Ireland. The report notes that various sources put the proportion of homeless people suffering from mental illness at between 30% and 50%.
There is no special psychiatric unit for prisoners – I am glad the Minister for Justice, Equality and Law Reform is here as well – and the only psychiatric hospital to accept prisoners is the Dublin Central Mental Hospital, which has insufficient beds for the demand, resulting in many mentally-ill patients in need of in-patient care never receiving a transfer.
Within the mental health service clinical resources are concentrated in the least deprived rather than the most deprived areas. The most deprived areas have, subsequently, fewer acute beds, larger sector sizes and a greater consultant staffing rate. I refer to the Irish Psychiatric Association report, which was published two weeks ago.
There is no special neuro-psychiatry service available for brain injury, brain disease or for those with psychiatric disorders as a result of a neurological disease. These patients do not receive any specialised treatment in this State.