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Dáil Éireann díospóireacht -
Wednesday, 25 Mar 1992

Vol. 417 No. 6

Adjournment Debate. - Mental Hospital Reports.

I thank you for allowing me to raise this matter and the Minister for coming into the House to respond. I should say at the outset that I do not hold the Minister responsible for the great lapse that I have identified. I do not know the reason for this but it has not been given the attention needed.

Section 247 of the Mental Treatment Act, 1945, states that "the Inspector of Mental Hospitals shall, in respect of each year, make to the Minister a report upon every mental institution...and the care of patients therein, and shall include in such report a general account relating to such year of the administration of the law relating to mental institutions and the care, welfare and treatment of persons of unsound mind".

When I went to the Oireachtas Library, which is a reference point when one wants to find out what is happening in relation to the care of patients in mental hospitals, to look for the reports I was surprised to learn that the last report published was for the years 1977-79 and was published in 1982. I asked where the other reports were, having regard to the fact that there has been a number of developments since 1979.

For instance, although the Health (Mental Services) Act was passed by the Oireachtas in 1981 it has not been brought into force. I would like to know what the Minister and the Department are going to do about this. In 1984 the Department of Health produced the report Planning for the Future. Can the Minister tell us if any of its recommendations have been implemented? There has also been a change from institutional to hostel based care while those found criminally insane are sent to the Central Mental Hospital in Dundrum. In recent years a number of people have been forcibly detained in mental hospitals against their will, which is the source of major concern. The most recent case was highlighted in the newspapers last Saturday.

All these matters should be reported on because we have an obligation to patients in mental hospitals, who have no voice and few rights. Indeed, many of them have been abandoned during the years by their own relations and no one knows what has happened to them or where they are. I should say that the inspector of mental hospitals is not functioning properly. After their release, those who had been detained sought in vain to obtain details from the inspector on the reasons they were detained. Indeed many of them did not even receive a reply. I am dealing here with a number of people and they feel very frustrated. This is unacceptable.

For these reasons I give the Minister the opportunity to explain what he is going to do about this matter. I ask him to make reports available for each of the years in respect of which we do not have reports in this important area so that we can see for ourselves what the conditions are in mental hospitals at present.

I thank Deputy Fennell for highlighting this issue. I would like to clarify at the outset that the last report on mental hospitals prepared by the inspector of mental hospitals and laid before each House of the Oireachtas was an amalgamated report in respect of the years 1977, 1978 and 1979.

I am fully aware of the statutory obligation placed upon the inspector of mental hospitals under section 247 of the Mental Treatment Act, 1945, to make an annual report to me on each psychiatric hospital and in the case of the Central Mental Hospital, Dundrum, under section 248 of the Act, and for each report to be laid before each House of the Oireachtas and a copy furnished to the President of the High Court. The Deputy will, however, be aware that following the presentation of the 1977 to 1979 reports the Department of Health concentrated resources on the preparation and drafting of fresh legislation intended to repeal all existing legislation in regard to the treatment of mental illness and to replace it with provisions which would have full regard to modern developments in the care of the mentally ill. This work culminated in the enactment of the Health (Mental Services) Act, 1981, which included provision for the registration and, more importantly, the supervision of the operation of centres for the care of the mentally ill.

The Act provided for the replacement of the inspectorate of mental hospitals with a provision for the inspection of psychiatric centres and homes by officers of the Minister for Health. The Act also repealed the Minister for Health's obligation under the Mental Treatment Act, 1945, to lay the inspection reports before both Houses of the Oireachtas.

The enactment of the Health (Mental Services) Act, 1981, was intended to provide the necessary legal framework to assist the future development of psychiatric services as envisaged by the study group appointed by the Minister for Health in October 1981 to examine the future development of psychiatric services. The growing uncertainties over the operation of this Act following its enactment, and in particular the implications for the repeal of sections 247 and 248 of the Mental Treatment Act, 1945, and the Minister for Health's obligation to the Houses of the Oireachtas, coincided with the Department of Health providing a dominant and leading role in the study group which published the report Planning for the Future published in 1984.

Notwithstanding the concentration of effort by my Department in assisting local health authorities in implementing the recommendations of the report Planning for the Future, particularly the fundamental shift from institutional to community based care for the mentally ill, I am acutely conscious of the time lapse since inspection reports on psychiatric hospitals have been laid before the Houses of the Oireachtas. I can assure the Deputy that an amalgamation of reports for the years 1988 and 1989 is at an advanced stage of preparation and will be presented to the House shortly. The report for 1990 is currently being compiled and will be completed in due course. I will see to it that the report for 1991 is made available within the next few months.

I would like to assure the Deputy that the current inspector of mental hospitals, who took up duty in late 1987, and his assistant inspector prepare detailed reports on their inspections of psychiatric facilities. Public psychiatric hospitals are inspected every year and private psychiatric hospitals once every six months. These detailed reports are sent to the chief executive officer of the responsible health board in respect of public psychiatric hospitals and to the person in charge of each private facility. In each case the chief executive officer or person in charge is asked to respond to the comments made on the hospital and the inspector's recommendations for improvements. These reports have been a major catalyst in improving standards of care in our psychiatric hospitals. As the inspector's annual reports will show when published, there have been major advances in the quality of life for patients in psychiatric hospitals in recent years.

My Department are currently preparing a discussion document on mental health which will outline the progress which has been made in the psychiatric service in recent years, identify service priorities of the future and suggest a new legal framework for the psychiatric services. The role of the inspectorate of psychiatric service will be an issue raised in the disucssion document for discussion with interestd parties.

On behalf of the Department, I would like to apologise to Deputy Fennell for the non-appearance of these reports. I will get what information I can as quickly as possible and make it available to Deputy Fennell.

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