Vol. 399 No. 7
10 Mr. O'Shea asked the Minister for Health if he has any plans to employ additional vocational training instructors or occupational therapists in the psychiatric and mental handicap services; and if he will make a statement on the matter.
It is a matter for health boards and voluntary service agencies to decide the most appropriate mix of staff within the resources available to them.
The allocation of £2 million made in the last budget for the development of mental handicap services will provide additional day and residential services for people with a mental handicap.
Will the Minister agree that, in relation to psychiatric patients, not mentally handicapped, there is a severe shortage of medium term places in psychiatric hospitals? Will he also agree that the system does not adequately cater for patients with personality rather than psychiatric problems? Will he agree that community psychiatric services are seriously under-resourced and that these factors are not unrelated to a high suicide rate among former patients of psychiatric hospitals? This awful situation underlines the need for additional occupational therapists and vocational training instructors.
In 1985, a report —Planning For The Future— by a working party on the psychiatric services was published and its recommendations are being implemented in each of the eight health boards as they determine the order of priority. However, I do not accept that there is an inadequate service for patients who suffer from psychiatric illness and there is no evidence that the rate of suicide has increased through any deficiency in the service. There has been an increase in the number of suicides and one of the reasons given is that there is a more accurate reporting of such cases now than formerly. We have moved a long way from the time when people were locked up permanently and, unfortunately, that in itself may lead to an increase in the number of suicides.
Does the Minister have reliable and comprehensive figures for the last three years in relation to suicides among former patients of psychiatric hospitals?
Reliable figures are available but I do not have them with me because they were not referred to in the question.
Is the Minister aware that there are substantial discrepancies and anomalies between health boards in relation to the number of occupational therapists? What proposals, if any, exist for attaining uniformity in this regard?
There is a variation between the health boards and, as I said in regard to an earlier question, it is a matter for the health boards themselves to determine their priorities regarding the staff they need. There are 36 occupational therapists employed in the mental handicap services and 31 in the psychiatric hospitals. We are trying to standardise the position in the health boards, particularly in the area of community care, which takes priority.
