I met the Inspector of Mental Hospitals recently to discuss his report and elicit his views about the areas of the mental health services which need improvement. The inspector has informed me that steady progress is being made across the country in the move towards an integrated, community based mental health service, but has emphasised that much remains to be done.
The inspector paid particular attention in his report to the innovative service developments that have taken place in the Cavan-Monaghan mental health service. He stated:
Very few mental health services in Ireland are truly innovative or willing to attempt new approaches to delivering mental health care. It is therefore refreshing to cite one example where considerable progress has been made in departing from convention. The Cavan-Monaghan mental health service has developed community outreach programmes for new patients and a rehabilitation service for those with enduring mental illnesses in the past few years.
The inspector noted that the results of the initiative were already being clearly seen in a reduction in the numbers of patients in the acute psychiatric units in both Monaghan and Cavan. I fully endorse the inspector's views on this service, and the Cavan-Monaghan model provides a most encouraging example of what can and should be achieved in a modern mental health service.
A number of other welcome developments were reported by the inspector in many of the health board regions during 2000. A significant development during the year was the opening of the new acute psychiatric unit at the Mercy Hospital, Cork in April 2000, which represented a major step forward for the north Lee service. Work had also commenced on the construction of the new acute units at St. Luke's Hospital, Kilkenny and the general hospitals at Portlaoise, Castlebar and Ennis. In the eastern regional area, the upgrading and improvement of conditions in the admission units in both St. Brendan's Hospital and St. Ita's Hospital were welcomed as was the appointment of a new consultant-led liaison psychiatric service at St. James's Hospital. Considerable expenditure had also been provided in upgrading the admission facilities in St. Loman's Hospital, Mullingar.
Community services were enhanced in a number of services. Developments included the opening of new day hospitals in Swords, County Dublin; Athy and Celbridge, County Kildare and Letterkenny, County Donegal; day centres in Balbriggan, County Dublin; Celbridge, County Kildare and Westport, County Mayo; extensive refurbishment and upgrading of community residences in the St. James's Hospital service; and the opening of supported residential accommodation in Newbridge, County Kildare; Rathdowney, County Laois; and Carndonagh and Letterkenny, County Donegal.
Additional information.
Concern was expressed by the inspector in his report at the lack of multidisciplinary teams in many mental health services, particularly in the area of psychology, occupational therapy and social work services. Additional resources were provided for health boards this year for the recruitment of paramedical staff for multidisciplinary teams. Many of these additional posts are now in place. However, some health boards have been experiencing problems in recruiting such professionals and a number of initiatives have been taken by my Department to deal with this issue, including the commissioning of a workforce planning study by Dr. Peter Bacon and Associates, increasing the number of student places in the therapy schools, and implementing the recommendations of the expert group report on various health professions. Increased availability of multidisciplinary teams around the country will serve to address the problem noted by the inspec tor, that drug treatment was often the only treatment option available to patients.
In relation to the issues of quality and efficiency, guidelines on good practice and quality assurance in mental health services were produced by the inspectorate of mental hospitals in 1998 and distributed to all service providers. Under the new Mental Health Act, signed by the President in July, the Mental Health Commission will be established to act as an independent agency to promote, foster and encourage the achievement and maintenance of high standards and good practice in the delivery of our mental health services. I hope to appoint the members of the Mental Health Commission within the next few months.