Dr. Matthew Sadlier:

The Senator will be delighted to know we use the International Classification of Diseases, which is a World Health Organisation, WHO, document. The DSM is published in America by the American Psychiatric Association.

I do not think from an academic perspective that we have over-medicalised mental health but when that distils down to treatment sometimes, yes, it is unarguable. When we say one in six teenagers and 50% of the population have a mental disorder some of that is phobias. While I do not wish to be dismissive of people with those problems, it is not as serious as schizophrenia or illnesses like that and treatment is usually relatively straightforward and recovery rates are quite high. They can be treated sometimes outside statutory services. The Senator is absolutely right that we need to have sensible referral pathways and guidelines towards the treatment of these disorders. There is an element of public information regarding the use of antidepressant medication.

As Dr. Walley said on the subject of antibiotics for illnesses, people tend to feel their problem is not being validated if they do not get a prescription for an antibiotic. Public information is necessary to persuade people that not every problem requires medication and that alternatives are available. Psychotherapy is often recommended but I would also recommend occupational therapy and a good study was done by the mental health service in north Dublin, where I was working, and the FAI into running a football programme. It involved kick start football training one day per week and was found to be incredibly effective. Such interventions, on the part of organisations such as the FAI, the IRFU or the GAA, have a community and social involvement and that can help.

Opiate services are our Cinderella services and we have called for drug detoxification units for a number of years, because they are lacking at the moment. Detoxification is the hardest thing to achieve, especially for people who have difficulties with alcohol, opiates or benzodiazepines, and withdrawal often needs medical management, which specialist drug detoxification units would aid.