Áine Brady (Kildare North, Fianna Fail)

Our current model of mental health care is largely institution-based, and 15 Victorian and older asylums are still in use. However, A Vision for Change, the report of the expert group on mental health policy, provides a framework for action to develop a modern, high-quality mental health service over a seven to ten year period and recommends that the remaining psychiatric hospitals should close and that patients should be relocated to more appropriate community-based settings.

The mental health capital programme will provide the infrastructure necessary for the patient-centred, flexible community-based service envisioned in A Vision for Change and will facilitate closure of the remaining hospitals. In this regard, Budget 2010 provided for a multi-annual programme of capital investment to be funded from the proceeds of the sale of lands. In 2010, the HSE will dispose of surplus assets and reinvest an initial sum of €50 million in developing the new mental health infrastructure. Projects which will be progressed in 2010 include the development of an acute unit at Beaumont to replace the acute unit at St. Ita's, Portrane; the construction of a community nursing unit in Clonmel which will enable St. Luke's Hospital to close later this year; and the construction of a community nursing unit in Mullingar to facilitate the closure of St. Lomans's Hospital. Approximately 300 patients with an intellectual disability are placed in psychiatric hospitals. Their needs, which relate to their disability rather than a mental health concern, will be addressed by the HSE in the context of the closure of the hospitals.

In addition to those inappropriately placed in psychiatric hospitals, it is estimated that approximately 4,000 people with disabilities reside in institutions or congregated settings. This includes a cohort of approximately 460 patients with an intellectual disability who are accommodated in specialised units which were formerly designated as psychiatric hospitals. Their needs will be addressed in the context of the review of congregated settings which is nearing completion. Congregated settings are defined as living arrangements where ten or more people share a single living unit or where the living arrangements are campus-based. The review will inform policy development on services for people with disabilities and specify a framework to guide the transfer of identified individuals from congregated settings to the community.

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