Dr. Shari McDaid:

I finally wish to speak about the question of efficiencies and whether they are being achieved. I have spoken about the fact that the overall budget has been cut. The reality, however, is that the way it is being done is to lose only retired staff and not develop community-based services. A study published this year showed that in County Kildare two services were working side by side. One service was largely hospital orientated, while the other included a day hospital involved in home treatment. They found that the hospital orientated service was 27% more expensive. The more that we cut staffing without providing community services, the more we will create a more expensive service rather than a cheaper one.

We can also see that it is not improving efficiencies when we look at things like admissions. Though overall admissions dropped slightly this year, we have seen that for the youngest age group - that is, people aged 20 to 24, which is when people often experience mental health difficulties for the first time - the rate of admissions per capita has gone up by about 20%. People are not getting the support in the community that they need. Some of those admissions are going up, and involuntary admissions are also up. While we do not have a direct correlation with this, we have also seen that the number of people who are being admitted to prison has gone up.