Léim ar aghaidh chuig an bpríomhábhar
Gnáthamharc

Dáil Éireann díospóireacht -
Tuesday, 25 Mar 2003

Vol. 563 No. 4

Mental Health Services.

I ask the Minister of State whether the conditions at the Ballyfermot Health Centre are acceptable in this century, because they were not acceptable in the last century. I have with me a number of photographs, which I will pass to the Minister of State when I am finished. The facility is akin to an airport hangar from the Second World War. Anybody who views these photographs will see the dereliction and dilapidation of which I speak. The condition of the facility is visible even from the outside: there is paint peeling from the walls and there are grilles everywhere. This facility is supposed to help people with mental health problems, but the first thing induced by such a facility is depression. This does not help the staff who are doing a tremendous job in the facility. It does not motivate them when they arrive to work in the morning.

The centre is too small for both the client base and the number of staff based there. The canteen facilities are very poor. Recently, one of the staff was seriously assaulted when he tried to prevent somebody from setting fire to the facility, although the staff have been calling for over two years for extra security precautions to prevent such an occurrence. At the very least, the centre should be kept clean, attractive and user-friendly and should reflect the care we give to those who are ill. It should be a centre of excellence. The state of this facility and the lack of resources it receives say a lot about the priority we give to the sick, especially those who have a mental illness and who may not be able to judge properly the world around them or speak up for themselves. Nobody is looking for a four-star facility; the staff and the users are only seeking the bare minimum.

Amnesty International has called the state of mental health care in Ireland shameful and has pointed out that services are inadequate and under-resourced. We are seriously out of step with international best practice and have failed to comply with international human rights law. That is an indictment of the State. I ask the Minister at the very least to address the problems faced by this centre, but he should also deal with the many other centres that deal with this affliction. One in four Irish people suffer from mental illness and require some type of treatment.

I asked related questions earlier in written form and the answer I received was that responsibility lay with the Eastern Regional Health Authority. The Minister still has an overall responsibility to ensure that the health authorities make sure that such facilities are of the best standard in the world. We should set a standard of excellence that other countries look to mirror. We have ratified a UN convention recognising the right of everybody to enjoy the highest attainable standard of mental health and the best available mental health care. Looking at these pictures and talking to some of the users and staff of this facility, one can tell that this is not available in the Ballyfermot Health Centre.

The Government has failed to act on a serious of reports, both international and national, critical of inaction on the human rights of people with mental illness. We have failed to meet the standards outlined by the World Health Organisation and in the UN principles for the protection of persons with mental illness. It is not good enough to say that there is a problem with funding in all sectors of the health service. The crisis in this facility has not just emerged in the last couple of weeks. It has been an ongoing problem and it needs to be addressed as soon as possible, before another staff member is attacked.

As I said, the facility resembles an airport hangar. There are grills on every window. It would be interesting, if the Health and Safety Authority were to visit the site, whether it would pass muster. I doubt it. I am asking that adequate resources be put into the health sector, particularly towards addressing the problems I have identified, and that the health authority urgently address these problems.

The Minister for Health and Children has asked me to take this debate on his behalf and he wishes to thank Deputy Ó Snodaigh for raising this matter.

Advancement in the standards of care for psychiatric patients, following the recommendations of the report, Planning for the Future, remains at the heart of developing and improving psychiatric services. Planning for the Future recommended the establishment of a comprehensive, community-oriented mental health service as an alternative to institutional care for persons with mental illness. The shift in the delivery of services from predominantly hospital-based care to care in the community has been extremely successful in Ireland and undoubtedly the quality of care for persons with a mental illness has been enhanced by this development. It has resulted in a continuing decline in the number of in-patients, with a corresponding increase in the range of care facilities based in the community.

The building the Deputy refers to houses the sector headquarters, the day centre and the day hospital for the Ballyfermot area. The Minister has been informed by the South-Western Area Health Board that, in spite of a programme of refurbishment, involving redecoration, alterations and on-going maintenance, the building remains sub-standard in its prefabricated state. However, the board will endeavour to acquire suitable premises to replace this facility.

The building comprises myriad small offices. Overcrowding is not necessarily an issue, but it is acknowledged that there is a lack of natural light and ventilation in the waiting areas. While it is not ideal that the day centre and the day hospital are housed in the same building, the Inspector of Mental Hospitals assures the Minister that the service provided by the multidisciplinary teams to service users at this location is one of the best within the service generally. In their role as advocates for service users, staff have consistently raised the issue of conditions at this centre.

Every effort has been made by the South-Western Area Health Board to make the building as secure as possible for staff and clients. The incident to which the Deputy refers took place on Friday, 7 March 2003. As this case is sub judice and the matter is currently being dealt with by the Garda in Ballyfermot, the Minister is not in a position to comment further on the matter at this time. In 1998, the Inspector of Mental Hospitals published guidelines on good practice and quality assurance in mental health services and these guidelines were issued to all service providers. The guidelines recommend that all staff should be trained in the techniques of management of violence and aggression through participation in a recognised training course.

Approximately €190 million capital will be provided over the lifetime of the national development plan for mental health services. While a significant part of this funding will go towards the development of acute psychiatric units linked to general hospitals as a replacement of services previously provided in psychiatric hospitals, it will also provide for more community facilities such as mental health centres and community residences, which will accelerate the phasing out of the old psychiatric institutions.

Substantial progress has been made in recent years to ensure that those in need of mental health services receive care and treatment in the most appropriate setting. However, it is accepted that much remains to be done and the Government is committed to the provision of quality care in the area of mental health.

The Dáil adjourned at 10.40 p.m. until 10.30 a.m. on Wednesday, 26 March 2003.

Barr
Roinn