Dan Neville (Limerick, Fine Gael) | Oireachtas source

I thank the witnesses for the information in their presentations. I wish to raise one or two issues. One concerns advocacy for mentally ill patients, which is a difficult area. As regards the ethos or practice of many sections of the psychiatric service - I am not painting the whole service with the same brush because there are good communicators - many psychiatrists will refuse even to discuss aftercare with carers, including families. We get this information all the time and it is a historical thing, not something that has developed recently.

In addition, the psychiatric profession sometimes seems to discuss issues almost as if the patient was not present. They may even assume the patient is not in a position to understand or be involved in his or her treatment. We are coming from a time when that was the practice in society concerning the mentally ill. What is the experience of the witnesses in this regard?

I understand that the Irish Advocacy Network does work in the area of mental illness, but it is not represented here. It specifically does peer advocacy. Where somebody has experienced difficulties with treatment from the mental health services, if trained properly in advocacy, such a person would be very suitable and informed. He or she would have a feel for people's expediences in mental health services and who may not have received the respect of being communicating with.

As regards communication with patients who are mentally ill, the more severe the mental illness, the less discussion that takes place with the patients themselves. There is almost an assumption that such a person is not cognitively able to engage about his or her illness, while that is not the case at all.

It is probably a historical societal practice going back decades, but it is still there. How do we move away from that?

On the issue of communicating with carers, where a family receives a person home from a psychiatric inpatient unit - I will deal with inpatients because outpatients have an issue as well - and the family is not informed of the aftercare, what to expect or what even the treatment might be, that is very stressful for the patient and the family and does not assist the full recovery. We are moving into recovery rather than containment because recovery is real in the mental illness area. The witnesses might cover those two areas.