Dáil Éireann Debate, Thursday - 2 December 2004
7 Mr. P. McGrath asked the Tánaiste and Minister for Health and Children if she will report on the provision of services for persons with eating disorders in all health boards or their equivalent; and if she will make a statement on the matter. [31777/04]
Amharc ar fhreagra28 Mr. Deasy asked the Tánaiste and Minister for Health and Children her plans for the improvement and development of services for persons with eating disorders; and if she will make a statement on the matter. [31776/04]
Amharc ar fhreagra55 Mr. Hayes asked the Tánaiste and Minister for Health and Children her views on a report, A Report on Service Provision in the Eastern Region; and if she will make a statement on the matter. [31775/04]
Amharc ar fhreagra68 Mr. Kehoe asked the Tánaiste and Minister for Health and Children her views on whether it is adequate that the tertiary referral service for eating disorders available in St. Vincent’s Hospital, Elm Park, Dublin has three inpatient beds designated for this purpose; if she has plans to increase the number of beds; and if she will make a statement on the matter. [31778/04]
Amharc ar fhreagraI propose to take Questions Nos. 7, 28, 55 and 68 together.
Persons presenting with eating disorders are generally treated through the psychiatric services of their local health board. Outpatient psychiatric services are provided from a network of hospitals, health centres, day hospitals and day centres. Where inpatient treatment is deemed necessary, it is provided in the local acute psychiatric unit or hospital, with beds allocated on the basis of patient need at any particular time.
A tertiary referral service for eating disorders is available to public patients in St. Vincent's Hospital, Elm Park, Dublin at which three inpatient beds are designated for this purpose. A similar service is available privately at St. Patrick's Hospital, James's Street, Dublin and St. John of God Hospital, Stillorgan, County Dublin.
The voluntary organisation Bodywhysprovides advice and support for sufferers of eating disorders, their families and carers. My Department has provided funding of €394,000 for Bodywhys since 2001 to develop its activities in this area.
The report referred to by Deputy Hayes is entitled, A Report on Service Provision in the Eastern Region, and was written by Joy Wall for Bodywhys. The report details the nature of eating disorders, the services available to those suffering from the disorder in the eastern region and makes recommendations for the future development of such services.
As Deputies will be aware, an expert group on mental health policy is preparing a national policy framework for the further modernisation of the mental health services. The provision of services for people with eating disorders is among the issues being considered by the group. I understand a copy of the Bodywhys report has been provided for the group which is expected to report in mid-2005.
As regards the lack of services for adolescents with eating disorders, I was informed recently that young people with eating disorders are literally fading away, both physically and mentally, in institutions totally unsuitable for their condition. Is it acceptable that just three public beds are available to treat adolescents with eating problems? Beds are made available in private hospitals at the discretion of the health boards. I know from experience that difficulties have arisen in accessing such beds and getting the health boards to cover the cost. The idea in all of this is that there is no equality of services for people with eating disorders. This report shows up a glaring inequality, especially when it comes to adolescents, who are often treated inappropriately in psychiatric institutions. Does the Minister not agree that this represents the lack of service to patients in this country?
I thank the Deputy for his response. The report points out inadequacies in the service, glaring inadequacies in the training of general practitioners in this area and a great disparity between the provision of services for public and private patients with anorexia nervosa and bulimia. This is in spite of the fact that the Department has appointed approximately 50 adolescent psychiatrists in recent years. Nonetheless, there are great anomalies in the service. The expert group will examine this report and take into consideration what the author says. Such inadequacies are not acceptable and I look forward to the recommendations of the expert group.
Is the Minister of State aware that the percentage of the overall budget for mental health services has dropped again, from 6.69% to 6.15% of the total budget? This in turn has dropped from 11% in 1997. One of the problems for the child and adolescent psychiatrists is that they have very few support staff. The Department may have appointed extra psychiatrists, but the lack of support staff will cause many problems in certain areas.
That statistic is not correct. The figure is approximately 7% at present, which represents €757 million for mental health services this year. I agree it is not sufficient, but it is not all about money. There are other problems in the area of mental health that are coming to the fore. There is a great disparity between the provision of services for public and private patients. We must examine that because it is not all about money. It is about reforming the practices that have been the norm for several years. I am delighted that there are organisations such as Bodywhys which highlight the inadequacies in the service. In meetings that I have held, many general practitioners have informed me that their undergraduate training in mental health is inadequate. The president of the Irish College of General Practitioners openly admitted in public that the undergraduate training of medical doctors in mental health is inadequate.
Does the Minister think that the lack of investment in the psychiatric services, especially for young people, has contributed to the very high suicide rate among young people?
The doctor might be able to give me statistics on the connection between suicide and eating disorders. Some patients might take their own lives, but it would be a very small number. Anorexia nervosa and bulimia are two medical conditions in their own right and there may be no intention on the part of the patient to take his or her life.
