Mr. John Saunders:

I thank the Deputy. I agree tele-psychiatry is not a substitute. Mental health care services across all programmes are about people reacting with people and support far more than in general medicine and other forms of health. There is room for tele-mental health or e-mental health, but it has a very specific purpose. In general, one should never try to replace people with machinery in the area of mental health.

I agree totally with Deputy Harty on that.

The second point to note to which the Deputy, and all of us, have alluded is that the community health teams are incomplete. People are working under pressure to provide a complete service with half the team. To use the analogy, how will a football team win a game if half its team members are not on the pitch? It is as simple as that. It is a complex problem to solve but it is simple. We do not have the right people in the right place to provide that service across the country.

On the issue of drugs, I respect all views around that. There is a history in mental health and in other parts of services of people relying on drugs because of the absence of something else. Equally, I am sure drugs work in certain cases. A number of years ago, the commission did a piece of research on benzodiazepines use in older populations and showed clearly that there is usually an over-prescribing of maximum doses in those cases. One rationale for that would be that there is no other way of managing people's behaviour, which is wrong. I have no doubt that in medicine generally, people sometimes resort to the prescription in the absence of other solutions.