Tim O'Malley (Limerick East, Progressive Democrats)

I thank Deputy Andrews for raising this matter. The World Health Organisation's 2001 mental health report confirms psychoses represent a major public health problem. Psychotic disorders include schizophrenia, drug-induced psychosis, some forms of bipolar disorder, depression and psychotic symptoms associated with epilepsy and other organic conditions. Worldwide, psychosis ranks as the third most disabling condition and poses an enormous burden in human suffering and economic cost.

Psychosis affects approximately 75,000 people, some 3% of the population. It is characterised by a loss of contact with reality leading to disturbances in perception, cognition, feeling and behaviour. Although psychosis can be a result of multiple factors including stress, withdrawal or intoxication with substances, medical conditions and mood disorders, most commonly it signals the onset of schizophrenia.

Each year more than 800 people, mainly young people, develop schizophrenia, the most common psychosis. The experience of psychosis has a profound impact on the individual, their family members and friends. A first episode of psychosis most often occurs in adolescence or early adult life, a critical period in human development and has great potential to derail education, work and social goals. The early identification and appropriate treatment of psychotic illness is the key to success of treatment and long-term prognosis.

To address the need for early diagnosis of serious mental illness in young people, DETECT, the first pilot project for early intervention in psychosis assessment was established. The service is provided in the south Dublin-east Wicklow area by the Health Service Executive, HSE, in collaboration with the St. John of God Hospital in Stillorgan. The pilot project began with an allocation of €500,000 from the 2005 HSE development funding for mental health services. The model offers an intensive multidisciplinary-based mental health assessment to confirm the diagnosis of psychotic illness.

Preventive interventions in psychotic disorders are now a realistic proposition. The approach of DETECT is consistent with the recently launched report of the expert group on mental health policy, A Vision for Change. This report is the first comprehensive review of mental health policy since Planning for the Future, and has been accepted by Government as the basis for the future development of mental health policy. A Vision for Change acknowledges the relationship between the length of time it takes to respond to an individual's first experience of psychosis and the long-term outcome for that service user. It recommends that, in addition to the DETECT project, a second early intervention service pilot project should be undertaken with a population characterised by a different socio-demographic profile. This will be undertaken with a view to establishing the efficacy of early intervention service for the mental health service.

The provision of early intervention services is also in accordance with Reach Out: The National Strategy for Action on Suicide Prevention 2005-2014. The strategy includes the development of a fast-track priority system from primary care and early intervention services to community-based mental health services. It also commits to further funding and evaluation of pilot service initiatives which aim to improve the early detection of psychological distress and mental health problems through community outreach work. This year an additional €1.2 million was allocated to the national office for suicide prevention. In 2006, €25 million was allocated to the HSE for the further development of our mental health services. In accordance with the HSE's functions under the Health Act 2004, the HSE's strategic planning and reform implementation innovation fund is considering the extension of funding for this project and a decision is expected by the end of May.

The Government is fully committed to funding a comprehensive early intervention service for psychosis which will improve the recovery prospects of service users and form part of our efforts to tackle the rate of suicide among young people.

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