Dan Neville (Limerick West, Fine Gael)

I welcome the opportunity to contribute to the debate because I also wish to raise issues concerning the health service, particularly its Cinderella, namely, psychiatric services. It is a disgrace that in the Administration's lifetime, the contribution to psychiatric health services has fallen from 11% to 7% of the total health budget this year. Bearing in mind that at some stage in his or her life, one in four people will suffer psychiatric or emotional difficulties requiring assistance, the Government is neglecting an important issue. The Government is protected by the stigma surrounding the matter because people are slow to talk and complain about the treatment of the psychiatric health service.

In the past week, the debate between various psychiatrists and the Minister of State at the Department of Health and Children with special responsibility for disability and mental health services, Deputy Tim O'Malley, epitomised how little has been done because the same debate took place 20 years ago when a report was published. It was accepted as Government policy that there would be multidisciplinary psychiatric services with a significant input from the psychotherapy sector.

Despite an agreement to deal with the matter some 22 years ago, a Minister of State is today saying that we should debate it. Every Government since that time has accepted that psychotherapy and multidisciplinary teams, including family therapy, occupational therapy and clinical nursing, should be part of an holistic approach to psychiatric services, but the neglect in building those teams has created a neglect in developing the services.

I urge the Minister of State to change the reduction and increase substantially the percentage of funding needed to develop psychiatric services. Last January, a new report entitled A Vision for Change, which included 50% of the earlier report's recommendations, also accepted all of the recommendations. It was déjÀ vu. This time, we urge the Government to invest seriously in psychiatric services to bring them to at least the level found in neighbouring countries, namely, 12% of the total health budget.

In 2004, the Mental Health Commission, a State agency, stated: "Under funding is reflective of the prevalence of mental disorder and generally negative and stigmatised attitudes towards mental illness generally." It also stated:

The provision of and quality of mental health services have received a low priority over decades. Despite report after report on the need to properly resource, refocus and reorganise the mental health services to make them patient-centred, community based and comprehensively available, the services remain below par for many of those who need them.

It went on to state:

The standard of care for patients in large psychiatric institutions has been severely criticised by the Inspector of Mental Health Services in his 2005 report. Despite repeated Government pledges to close these institutions, just four have closed over the past 20 years and patients continue to be admitted to long-stay wards. Many of these wards have little or no therapeutic activity, multidisciplinary input, regular physical or psychiatric assessments or care plans for patients. Community residences for former long-stay patients were found by the inspector to be an "exercise in relocation rather than part of a rehabilitation programme".

Approximately 5% of people over 65 years of age suffer from some form of dementia and a further 15% to 20% suffer from other mental problems, such as depression and anxiety. These problems are normally of a mild severity but a significant proportion require specialist intervention, which is not happening. I urge the Government to address the needs of those people. Homeless people are far more likely than the general population to be mentally ill and very little is done to treat mental illness among the homeless and prisoners.

See this speech in context