Joe Costello
Ceist:361 Mr. Costello asked the Minister for Health and Children his views on the particular concerns in correspondence (details supplied); and if he will make a statement on the matter. [4410/03]
Written Answers. - Autism Services.
The number of persons with an intellectual disability or autism accommodated in psychiatric hospitals in October 2002 was 452, down from 490 in April 2002. The figure in 1996 was 970.
Between 1999 and 2002 additional revenue funding of €10.476 million and €27.4 million capital funding was allocated to the programme to provide more appropriate care settings for: persons with an intellectual disability and those with autism accommodated in psychiatric hospitals; those accommodated in de-designated units, which were formerly designated as part of the psychiatric services; and others who moved some years ago from psychiatric hospitals to alternative accommodation which is now unsuitable for their needs.
Examples of recent developments include: the transfer of more than 60 persons in the Mid-Western Health Board from St. Joseph's Hospital, Limerick, and Our Lady's, Ennis; 29 persons from St. Finnan's, Killarney; 21 persons from St. Canice's, Kilkenny; and 30 persons from St. Joseph's Service, St. Ita's, Portrane.
Other centres, apart from psychiatric hospitals, which have received revenue and capital funding include St. Raphael's, Youghal, St. John of God House, Enniscorthy, Alvernia Centre, Portlaoise, St. Peter's, Castlepollard, Lough Sheever, Mullingar, Sean O'Hare, Stranorlar, Cloonmahon, Sligo and Áras Attracta, Swinford.
This programme not only encompasses a capital investment in new or refurbished facilities, but also aims to enhance the staff numbers and skill mix working with this group and the quality of services available to them.
It has been the policy of my Department for 15 years that persons with an intellectual disability or autism should not be admitted to psychiatric hospitals unless they have an underlying psychiatric disorder which cannot be appropriately treated elsewhere. In the case of St. Ita's Hospital, persons with an intellectual disability or autism are admitted to St. Joseph's Intellectual Disability Service, which, while it is based on the St. Ita's campus, is a specific and dedicated intellectual disability service.
My Department understands from the Midland Health Board that it is the board's current policy to provide in-patient psychiatric services for adult persons with mild intellectual disability and-or autism within the general adult psychiatric service. Residential treatment, when required, would be provided in the board's psychiatric in- patient facilities while treatment is being given. For adults with moderate, severe or profound intellectual disability and-or autism who require residential psychiatric treatment the board will, in the first instance, endeavour to treat the individual in their current residential setting. Where this proves to be inappropriate the board utilises the existing psychiatric in-patient facilities.
I have been informed that the board has been developing psychiatric services for both children and adults with intellectual disability and/or autism. At present, a psychiatric consultant led team provides services for children up to the age of 18. The board advertised for a consultant psychiatrist specialising in adult intellectual disability and autism in November 2002.
The psychiatric and disability services have been working closely in seeking to secure appropriate accommodation for the small number of people currently resident in the board's psychiatric hospitals requiring specialised accommodation.
I understand from the board that its psychiatric service, in line with best practice, does not engage in the use of strait-jackets. I also understand that the utilisation of seclusion rooms is highly regulated and their use is monitored by both hospital management and the Inspector of Mental Hospitals. They are only used in exceptional circumstances. Where an individual is placed in seclusion it is at the request of the treating consultant, and individuals are kept under constant clinical observation for the period of seclusion.