Michael Creed
Ceist:22 Mr. Creed asked the Minister for Health the steps, if any, he will take to ensure the treatment of patients with alcohol disorders occurs other than in mental hospitals.
Written Answers. - Treatment of Patients with Alcohol Disorders.
Richard Bruton
Ceist:25 Mr. R. Bruton asked the Minister for Health the steps, if any, he will take to ensure the treatment of patients with alcohol disorders occurs other than in mental hospitals.
Michael Finucane
Ceist:73 Mr. Finucane asked the Minister for Health the steps, if any, he will take to ensure the treatment of patients with alcohol disorders occurs elsewhere than in mental hospitals.
I propose to take Questions Nos. 22, 25 and 73 together.
Alcohol related problems make a heavy demand on our psychiatric services. Traditionally those suffering from alcohol related problems have been treated in our psychiatric hospitals. This approach often involves costly in-patient care which tends to separate the treatment and management of alcohol related problems from the environment in which they occur.
However, the report of a study group on the development of the psychiatric servicesPlanning for the Future published in 1984 recommended that the emphasis in management of alcohol related problems should be on community based intervention rather than on specialist in-patient treatment.
Detoxification facilities for persons who have consumed excessive amounts of alcohol have until recent years been located either in the controlled environment of psychiatric hospitals or in general hospitals. Alternative detoxification centres are currently being developed for use by persons who, following medical assessment, are deemed suitable for detoxification in a community setting such as a day hospital. There would, however, continue to be a need for detoxification facilities in hospitals and a small number of residential places for people who, for social reasons, cannot benefit from day programmes.
The recommendations ofPlanning for the Future on alcohol related problems were endorsed in the Green Paper on Mental Health published by my Department in 1992. With the shift in emphasis towards out-patient treatment and counselling, it proposed that consultant psychiatrists would spend more time in training other members of the inter-disciplinary teams and in counselling and advising members of the primary care services. It noted that the role of the specialist service should be to support the general practitioner in resolving alcoholrelated problems in the context of the health of the individual and family as a whole. It also envisaged an important role for nurses and social workers.
In line with this approach, comprehensive community-based alcohol treatment programmes are being promoted. Health boards which have not already developed local alcohol treatment services are being encouraged to do so and to consider ways in which services provided by voluntary and private organisations can be integrated with health board services.
Ultimately the emphasis in regard to alcohol related problems should be on their prevention. This is a key element in the formulation of a national alcohol policy being developed by my Department's health promotion unit wherein the broader economic, social, educational, cultural and health factors which impinge on alcohol use and misuse are addressed. Work on the development of this policy document is at an advanced stage and I expect to have the final draft before me shortly.