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Dáil
‹ Leaders’ Questions.

Mental health services

Summary

Kenny highlighted the scale of mental illness and shortcomings in services, pressing for a Cabinet task force and better provision, including for teenagers. The Taoiseach cited community-based services, additional resources, and the Mental Health Commission and inspector, but did not directly address each proposed measure.

Next Sunday, 10 October, marks World Mental Health Day. This Government has very little to be proud of in that regard. The statistics regarding mental health in this country are truly frightening. Over 300,000 people suffer from depression. One in every nine people has or has had some form of mental illness. The Irish College of Psychiatrists said that one in four people will be affected by mental illness at some time during their lives. A study commissioned by Mental Health Ireland and conducted by pollsters found that three quarters of the population know someone close to them who has or has had mental illness at some time during their lives, mostly depression. As the Taoiseach is well aware, Ireland has the highest rate of suicide among young men in Europe. It is perverse that while suicide rates in Ireland rank at over 450 per year, more than tragic motor accidents, the Government has refused and so far failed utterly to implement the Report of the National Task Force on Suicide.

What is the Government's strategy to deal with mental health, now that the Fianna Fáil members of the Government at least have a new understanding of social inclusiveness and what it means to have a caring society? What are the Taoiseach's targets for budgetary expenditure on mental health this year? He is aware that in 1997, 11% of the total health budget went towards mental health. It is down to 6.6% in 2003, despite the fact that the World Health Organisation made a general recommendation that it should be of the order of 14%. What does the Taoiseach propose to do about that this year, in view of the fact that the Minister for Finance has a bulging bag of money to dispense?

Comment on this

The Government is committed to developing a high quality, community based mental health service and we provided significant additional resources to achieve that. It has been the view since the mid-1980s that we should try to move from old mental health institutions to providing a far better community based service where back-up staff would be available, both psychiatrists and psychologists, care workers and care nurses, who would be actively engaged in the community in trying to move people from the old large institutions into the community where they could live in collective housing. That has been the policy for the best part of 20 years and it continues to move on.

Deputy Kenny asked what we are doing currently. In excess of €90 million in additional revenue has been invested in mental health over the past few years to build on that service. The Deputy also asked about the total mental health budget. It is now €661 million, which is a considerable expenditure. On the capital side, new acute psychiatric units have opened recently in both Kilkenny and Castlebar, bringing the total number of such units in the State to 21. We recently allocated €10.7 million to James Connolly Memorial Hospital to fully commission the new units, including the 56 bed acute psychiatric unit. While acknowledging that a delay occurred in that project it is now moving ahead at full speed, and this will help in the mental health area. We have also provided resources for the recently opened 50 bed acute psychiatric hospital in Portlaoise General Hospital.

On the general front, the Mental Health Commission was established two years ago to foster high standards and good practices in the delivery of mental health services and to ensure the interests of people who have been detained are protected. As Members of the House will be aware, that is also an important issue. The Expert Group on Mental Health Policy has commenced work on the preparation of a new national policy framework for the future development of mental health services to which the Government is committed.

We have a new inspector of mental health services who has replaced the former Office of the Inspector of Mental Hospitals, something which had created much difficulty in the area over the years. That person was appointed by the Mental Health Commission. The new inspector is required to visit and inspect approved centres at least once a year, preferably more often.

I agree with what Deputy Kenny said about the rate of suicides here, particularly among males. It is exceptionally high but both the Department and the agencies have long undertaken research to determine what we and the agencies can do collectively to assist people, which they are trying to do.

Comment on this

I will tell the Taoiseach some measures he can take. In his reply the Taoiseach indicated some of the targets set out in a 1984 report on mental health, many of which still have not been achieved. He spoke about allocating €90 million for mental health services since 1997, yet persons sitting beside the Taoiseach allocated €50 million in one year for electronic voting, the machines for which lie in storage throughout the country.

Comment on this

Costing a great deal of money.

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Yesterday, the newspapers reported that 80% of those on tranquillisers in Ballymun had been on them for over 12 months when medical recommendations are that persons should not be using them for more than two weeks.

I want to ask the Taoiseach about four measures he says he will take. First, will he set up a ministerial task force at Cabinet level to tackle mental health and bring it to a summit, such as happened with regard to traffic business some weeks ago? Second, will he set up a dedicated psychiatric service for 16 to 18 year olds? Will the Taoiseach confirm that nobody with an intellectual disability will be left any longer in a psychiatric institution? Will he ensure the report of the task force on mental health is implemented, and set target dates for it to be finalised?

Comment on this

The Department of Health and Children is either dealing with, or is involved in, these matters.

Comment on this

Or it is not dealing with them.

Comment on this

The Mental Health Commission was set up two years ago on the principle of providing and fostering far higher standards and good practices in the delivery of mental health services, and to ensure the interests of people detained are protected. The Government is committed to doing that. The new inspector of mental health services has replaced the Office of the Inspector of Mental Hospitals and is required to visit and be aware of the circumstances of people detained in hospitals and of anyone held against his or her will or in an unfair and unreasonable fashion. The Government is committed to providing resources. We gave €90 million in 1997 and every year since then have continued to increase the base figure bringing it to €660 million today.

Deputy Kenny referred to the 1984 report which set a blueprint for changing what had been happening since the 1870s in mental health services, and for moving away from institution-based confinement areas to place people in the community. Since then the Department of Health and Children and the mental health sector have moved on those proposals to provide acute beds in hospitals for mental health patients and for those who do not require to be in hospital, to provide a strong community base with very good services whereby people are visited daily.

Comment on this

That is not true.

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Those units in the various health board areas have changed the lives of people with mental health problems. We are committed to continuing to enhance that service.

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