Ceisteanna – Questions. - Mental Health Services.

Wednesday, 7 May 2003

Dáil Eireann Debate
Vol. 566 No. 1

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  55.  Mr. Neville  Information on Dan Neville  Zoom on Dan Neville   asked the Minister for Health and Children  Information on Micheál Martin  Zoom on Micheál Martin   if he will produce a plan with a timetable to deal with the Government's failure to respect the human rights of people with mental illness. [12233/03]

Minister of State at the Department of Health and Children (Mr. T. O'Malley): Information on Tim O'Malley  Zoom on Tim O'Malley  The Amnesty report, Mental Illness – The Neglected Quarter, published earlier this year acknowledges the significant advances made in this country in the provision of community psychiatry, nursing services, community residences, day hospitals and day centres since the publication of the landmark 1984 report, Planning for the Future.

Between 1999 and 2002, an additional €70.7 million was invested in the mental health services. In the current year, additional revenue funding of €7.6 million will be provided for ongoing improvements in mental health services; to develop and expand community mental health services; to increase child and adolescent services; to expand the old age psychiatry services; to provide liaison psychiatry services in general hospitals; and to enhance the support provided to voluntary agencies.

[5]Approximately €190 million in capital is being provided over the lifetime of the national development plan to fund the development of acute psychiatric units linked to general hospitals, as a replacement of services previously provided in psychiatric hospitals. Substantial progress has been made. A total of 19 psychiatric units attached to general hospitals are operational and a further two units will become available to their mental health services in the near future.

With regard to community residences, there are approximately 400 community psychiatric residences providing more than 3,000 places. This compares to 111 residences, providing less than 1,000 places in 1984. With regard to day hospitals-day centres, there are approximately 200 providing more than 3,500 places. This compares with 39 such centres providing approximately 1,200 places in 1984.

Additional Information.The Mental Health Bill was enacted in July 2001 and will significantly improve safeguards for mentally disordered persons who are involuntarily admitted for psychiatric care and treatment. The Act will bring Irish law in this area into conformity with the European Convention for the Protection of Human Rights and Fundamental Freedoms. The main vehicle for the implementation of the Mental Health Act 2001 is the Mental Health Commission, which was established on 5 April 2002.

The Mental Health Commission has an important role to play in improving the quality of our mental health services. The primary functions of the commission are to promote and foster high standards and good practices in the delivery of mental health services and to ensure the interests of detained persons are protected. The commission is working, along with officials from my Department, to put in place the structures required for its new role. The commission will shortly appoint an inspector of mental health services. The inspector will be required to visit and inspect all approved centres at least once a year. The inspector's annual report and review of the mental health services will be published and laid before the Houses of the Oireachtas, along with the commission's annual report.

The health strategy, Quality and Fairness – A Health System for You, includes a commitment to prepare a national policy framework for the further modernisation of the mental health services, updating the present policy document, Planning for the Future, which was published in 1984. All areas of service provision and mental health policy will be examined in the course of this work. It is intended that this process will begin shortly.

Funding has been made available to support groups and organisations such as Schizophrenia Ireland, Mental Health Ireland, GROW and Aware to heighten awareness and develop support services for service users and carers. In a concrete expression of the Government's commitment in the health strategy to develop advocacy services in mental health, €251,000 was provided by my Department to health boards and [6]voluntary agencies for this purpose in 2002. An additional €100,000 was provided in 2003.

Mr. Neville: Information on Dan Neville  Zoom on Dan Neville  Does the Minister of State accept the inattention paid by the Government, outlined by Amnesty International, to a series of national and international reports critical of its failure to fully respect the human rights of people with mental illness? Does he further accept Amnesty International's statement that Ireland is in contravention of more than ten international treaties on human rights by virtue of the service provided to the mentally ill? There is a severe shortage of psychologists currently. How many vacancies exist? How many people are in training to become clinical psychologists?

Mr. T. O'Malley: Information on Tim O'Malley  Zoom on Tim O'Malley  I do not have the exact number but I am aware that there are some additional places in UL and other colleges in regard to psychological services. I agree that there has been a lack of provision of these services. Apropos of the Amnesty report, the Government accepts and acknowledges that there are, and have been, grave deficiencies in the services in the mental health area.

Mr. Neville: Information on Dan Neville  Zoom on Dan Neville  And there continue to be.

Mr. T. O'Malley: Information on Tim O'Malley  Zoom on Tim O'Malley  The Government acknowledges that. Unfortunately, the lack of provision of services has existed for quite a long time. Both the last and the present Government have, as I outlined in my reply, invested a huge amount of resources and have provided a significant number of residential and community places as the Deputy is aware. I fully subscribe to the Deputy's view that sufficient work has not been done in the mental health area and I share his concern. I am sure it is the concern of every Deputy.

The Amnesty report also acknowledges that the lack of provision of services, and this is no excuse, is not particular to Ireland but is a world-wide phenomenon. The Government has provided, is providing and will continue to provide more services. As I said previously to Deputy Neville, it is not all about resources. In our health board area we have a particular problem which has nothing to do with resources. The Government has provided €2 million to fund a beautiful establishment which would allow 37 or 38 patients to leave St. Joseph's Hospital. The unit is fully furnished and ready but an industrial relations problem is delaying implementation.

I have done everything in my power to advance the issue. I have spoken to both the unions involved and the Mid-Western Health Board to expedite the matter. These discussions have now gone on for well over a year or year and a half and, unfortunately, progress is slow. This is just one example of where provision has been made for services and where 36 patients have already been selected to move out into the community. The services are there for them and the money has been provided. I understand the same thing is happening in other health board areas.

[7]Mr. Neville: Information on Dan Neville  Zoom on Dan Neville  It is disingenuous to blame industrial relations in view of the fact that the health budget has been reduced for mental health services from 15% to 7% in the space of ten years.

An Ceann Comhairle: Information on Rory O'Hanlon  Zoom on Rory O'Hanlon  Has the Deputy a question? We must move on to the next question.

Mr. Neville: Information on Dan Neville  Zoom on Dan Neville  Does the Minister accept that there has been a considerable reduction in the percentage of moneys to the mental health service in regard to the total budget for health over the past ten years?

Mr. T. O'Malley: Information on Tim O'Malley  Zoom on Tim O'Malley  Not in the past ten years. As I said in my reply, an unprecedented level of funding has been put into the mental health services in the lifetime of both this and the previous Government. The figures are there to prove it.

Mr. Neville: Information on Dan Neville  Zoom on Dan Neville  There has been an increase of 1% this year and we have an inflation rate of—

Mr. T. O'Malley: Information on Tim O'Malley  Zoom on Tim O'Malley  To say that I was disingenuous about industrial relations problems is not true as the Deputy well knows.

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