Written Answers. - Policy on Psychiatric Patients.

Liz O'Donnell

Ceist:

12 Ms O'Donnell asked the Minister for Health if he will make a statement on the policy of the phased release of psychiatric patients back into the community. [8752/96]

Liz O'Donnell

Ceist:

51 Ms O'Donnell asked the Minister for Health the procedures involved in the current policy of transferring psychiatric in-patients into the community; the number of such patients that have been so transferred in each of the last three years; the support services, if any, available to them; and if he will make a statement on the matter. [8891/96]

,Limerick East): I propose to take Questions Nos. 12 and 51 together.

As the Deputy is aware the report of the Study Group on the Development of the Psychiatric ServicesPlanning for the Future, which was published in December 1984, recommended a shift in delivery of services for the mentally ill from an institutional to a community-based service. Since then, the report has been adopted as policy by successive Governments and acute units in general hospitals, day hospitals, day centres and community hostels have been opened to replace services previously provided in psychiatric hospitals.

Other therapeutic interventions which have altered the delivery of psychiatric services include domiciliary assessment, community nursing and home support, respite care, out-patient clinics and clinical rehabilitation services.
Persons with mental illness are provided with a continuum of care from acute admission through care at home or in the community. Services for patients who are acutely mentally ill are provided in a hospital setting. When a patient has recovered from the acute phase of his-her illness they are discharged to the care of their general practitioner, in conjuction, where necessary, with the sector mental health team. Discharge from acute care is made on the basis of a clinical decision.
Prior to discharge from hospital, each patient is assessed individually to identify his-her psychiatric needs together with his-her personal strengths. Following assessment, a specially designed programme of rehabilitation is drawn up for each patient. Such programmes aim to cultivate the social, communication and vocational skills of the patient. The patient remains under the care of the mental health team for as long as he-she requires.
As the care of a person with mental illness is a continuum from acute admission to community based services, information on patients as requested by the Deputy is not available.
However, the report on Activities of Irish Psychiatric Hospitals and Units, published by the Health Research Board, indicates the following admissions and discharges from acute hospitals and units in 1992, 1993 and 1994:

All Admissions

Discharges (including Deaths)

1992

27,148

27,294

1993

27,005

26,860

1994

26,687

26,540

An advantage of the organisation of care for the mentally ill in this country is that the same authority — the health board — is responsible for medical and nursing care in hospital and in the community, the provision of housing for the metally ill in the community and the provision of sheltered employment. This has enabled services for the mentally ill to be provided in a more comprehensive way than is the case in other countries where these functions are divided among a number of agencies.