Vol. 566 No. 2
137 Ms O. Mitchell asked the Minister for Health and Children the plans in place to provide adequate safe supported housing for the mentally ill who are either unable to live at home or have been discharged from psychiatric facilities. [12447/03]
My Department issued guidelines on good practice and quality assurance in mental health services in 1998. These guidelines state that it is essential that well planned discharge policies and procedures are in place. Most patients are able to return home with little or no support, while others will require a package of care to support them and some patients with complex care needs may require continuing care from the community mental health service which may include supported housing accommodation. A clear discharge plan designed for the safe discharge of patients should be in place. This will include documentation and a pre-discharge checklist to ensure all appropriate information is given and all appropriate services are arranged prior to the patient's actual discharge.
Immediately following discharge, a discharge summary should be sent to the general practitioner and to members of the psychiatric services providing aftercare, setting out the principal details of the patient's management and treatment while in hospital, including medication on discharge and whether and for how long it is to be continued. The patient too should be supplied with a standard information form giving information on the drugs prescribed, the name of his or her general practitioner and the telephone number of the mental health centre or service where staff can be contacted and a domiciliary visit or other intervention carried out in case of an emergency. The type of aftercare planned for the patient should be discussed with the patient taking into account the patient's diagnosis, needs, physical and emotional and personal preferences. Arrangements must be made for the first review of the patient post-discharge.
An aftercare plan for the patient should be recorded in detail in the patient's case file and available to each member of the professional team responsible for the patient. The discharge plan should be drawn up by the patient's treating consultant psychiatrist and should fully consider and provide for the immediate and long-term needs of the patient and include an assessment of the risk of the patient harming himself or others. Aftercare should be properly co-ordinated and supervised under the general direction of the patient's treating consultant psychiatrist. A mechanism should be in place to review patients who have been lost to follow-up and everything possible should be done to find out what has happened to the patient and to take appropriate action.
The main difficulty in relation to adult homelessness has been in the Dublin area and, to address this, the Eastern Regional Health Authority, ERHA, has appointed a director of homelessness who is working closely with the three area health boards in implementing the provisions of Homelessness – An Integrated Strategy, May 2000. The work of the three area health boards includes measures to improve mental health services for people who are homeless.
Since 2000 the Department of Health and Children has allocated €18.34 million to health boards to deal with homelessness with an additional €2.66 million allocated for 2003. The recently published health strategy, Quality and Fairness – A Health System for You, includes a commitment to prepare a new national policy framework for the further modernisation of mental health services. Work on the framework is expected to commence later this year. All aspects of mental health service provision, including services for the homeless, will be examined and the need for additional research in this field will be among the matters for consideration.
