Mr. Jim Ryan:

I also receive a great deal of feedback from patients who contact my office telling me of their experiences of some of our services. In 1960 there were 20,000 people in psychiatric hospitals in Ireland. There are now 1,000 acute inpatient beds. We have one of the lower uses of beds across Europe. We have changed the model of care from institutional care to community care. That is challenging as we must ensure that our community services are in place to ensure that the beds that we do have are for those who need them most. I cannot condone the experience of that young woman. I understand that. I have responsibility for the Central Mental Hospital. There are people on the waiting list to come into the hospital from prisons. I understand issues like that on a day-to-day basis.

We have tried to do various things. In Galway last week, for instance, we opened a new 50-bed unit. It is a state-of-the-art unit that had been open for 12 months before being formally opened last week. We have opened units in Drogheda and Cork and have renovated Limerick and Sligo. We are trying to change the way in which mental health services are delivered but it is taking longer than any of us would hope.

I agree about budget and staffing. I am head of operations and obviously, I would prefer that we had more resources. The submissions we make are based on the need, particularly that outlined in our policy document, A Vision for Change. We must also recognise our ability to staff the units we have, and there is a constant issue with the recruitment and retention of staff in the psychiatric and mental health services.

There was a question about what to do during the day when one comes out of hospital. In Mayo in particular, we have a very strong recovery college based in Castlebar. Service users have been involved in setting up recovery colleges, including wellness recovery action plans, WRAPs, and other programmes that they have implemented. That is because we have a relatively small number of inpatient beds and we want people to be in there for the least time possible and we want something for them to plug into immediately when they do come out. We have employed peer support workers and service user leads who have a lived experience of mental illness and who are changing the way in which we are delivering services. I will not sit here and say that the experience that a person has had is anything other than unsatisfactory - I am not just saying that, I believe it personally and professionally - but I must try to work with what we have and to try to change things. I spoke about the budget and the increase in funding. I acknowledge that the budget increase is going from a low base. Mental health has about 6.7% of the overall health budget, whereas the equivalent figure in other countries is 8% or 9% but that is an issue which is above my pay grade. These are points we have made time and again.

I acknowledge what the Deputy said. We are always disappointed to hear when people have had bad experiences of our services. I know the unit in Castlebar and have visited it many times. I often ask myself what would I want if I was in that situation. We are trying to achieve a much better service so that when people are in there - for the shortest time possible - they are helped when they come out and have something else to do. Today, for example, as we speak the Minister of State, Deputy Jim Daly, is launching 30 specialist rehabilitation unit beds we have purchased from outside the HSE in two services in Dublin. We recognise there are those who have been in inpatient units in the long term, who have become institutionalised and who are unable to come out and get into a more meaningful life. We expect that within 12 or 18 months, those 30 beds in those two areas will make a significant impact and a difference. We hope to extend that across the country in coming years. We are making efforts but there are still deficits.