Mary Mitchell O'Connor (Dún Laoghaire, Fine Gael)
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On 22 February, I raised the issue of pro-eating disorder websites at a briefing on eating disorders by Bodywhys that coincided with eating disorder awareness week. These websites define and promote anorexia and bulimia as conscious choices and a lifestyle. They are called pro-ana and pro-mia websites and exploit the vulnerability of people whose ability to reason logically is impaired. Sites often contain sections such as thinspiration, with inspiring text and photos of very thin celebrities or manipulated photographs. A tips and tricks section offers information on the calorie values of certain foodstuffs and drugs, as well as suggestions to mask dieting behaviour and the anorexic body shape.

A study published online in the European Eating Disorder Review in January 2009 was based on research on school students in Belgium. Some 12.6% of girls and 5.9% of boys aged 13, 15 and 17 had access to pro-anorexic websites. Visiting such sites was associated with a higher drive for thinness and higher levels of perfectionism. No such figures are available for Ireland but, based on the number of people who have contacted me as a Deputy, ex-school principal and teacher, I have no doubt that the figures are just as depressing for Ireland. Bodywhys points to the dangers of the websites, such as that they are potential triggers into an unhealthy, destructive lifestyle, that people can get competitive about how thin they are, and that an unwell person can see weight loss control as an achievement whereas it is a reflection of obsessive and potentially deadly behaviour. These sites can encourage and maintain the disorder. They can be salacious, sensationalist and disrespectful of the dignity of people affected by eating disorders. They also show a lack of respect for professionals, clinicians and researchers who devote their time to the study and treatment of eating disorders and related problems.

America, France and the UK have made efforts to block access to such websites but have not been successful. It is important that Ireland also investigates ways to protect our young and vulnerable people and learns from actions taken by other countries.

Jan O'Sullivan (Limerick City, Labour)
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I thank Deputy Mitchell O'Connor for raising this important issue and I share her concerns. I am responding on behalf of my colleague, the Minister of State, Deputy Kathleen Lynch, who has responsibility for mental health issues. The Internet is an international and worldwide phenomenon. It has no borders and no single organisation controlling it. Therefore, efforts to combat harmful material and activities on it can be hampered by the multiplicity of jurisdictions, differing legal systems and differing societal norms.

In this instance, many of the pro-eating disorder websites which the Deputy refers to may be hosted outside this jurisdiction, principally in the United States. As such, they are subject to the US jurisdiction, the free speech provisions of the US Constitution apply and the action that could be taken against them here is limited. While acknowledging these difficulties, there is a self-regulatory framework in place for Internet service providers in Ireland. The Internet Service Providers Association of Ireland code of practice and ethics sets out clear guidelines and minimum standards in respect of dealing with complaints regarding suspected illegal material online.

Although treatment services was not the primary issue raised, a special allocation of €35 million was provided for mental health in budget 2012 in line with the programme for Government commitments, part of which will support the treatment of eating disorders. The €35 million funding will primarily be used to strengthen community mental health teams in both adult and children's mental health services. Over 400 additional staff will be recruited to support initiatives under this package. It is intended that the additional resources will be rolled out in conjunction with the scheme of appropriate clinical care programmes currently being developed. Three areas will be prioritised this year, one of which will be the treatment and care of patients with eating disorders.

HSE services for people with eating disorders are embedded in the community mental health service and with primary care. Individuals with eating disorders frequently present to the primary care practitioner with complications of their condition and early intervention at this level greatly improves outcomes. The HSE has developed a mental health in primary care accredited training programme for primary care practitioners with Dublin City University with a view to enhancing the capacity of primary care to recognise, assess and treat a range of mental illnesses, including eating disorders, within the primary care setting.

The HSE also provides funding to Bodywhys, the national voluntary organisation supporting those with eating disorders to which Deputy Mitchell O'Connor referred. Bodywhys provides a range of support services for people affected including specific services for families and friends. Bodywhys also works closely with the health promotion units throughout the HSE. I can assure the House on behalf of my colleague, the Minister of State, Deputy Lynch, that the management and care of eating disorders and mental health services generally will continue to be a priority for this Government. I will pass on the Deputy's concerns about the Internet and access to information.

Mary Mitchell O'Connor (Dún Laoghaire, Fine Gael)
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I am heartened to hear the response of the Minister of State. I am very concerned about the number of parents in my constituency who contacted me about these websites. I looked at them for research purposes and I was shocked by the images of thin people proffered as thinspiration. There is also the promotion of a bracelet project, where pro-mia or bulimic sufferers, are advised to wear blue beaded bracelets around their right wrists and pro-ana or anorexic girls are encouraged to wear red beaded bracelets around their left wrists, which allows children to identify other followers and foster a sense of community. We can be cocooned in the House and not realise what is going on with our vulnerable young people. Another website has a list of the thin commandments, containing instructions for sufferers such as "if you aren't thin, you aren't attractive", "what the scale says is the most important thing" and "being thin and not eating are signs of true willpower and success". These websites are promoting unhealthy and dangerous diseases as lifestyle choices. As a Government, I am glad we are exploring ways of protecting our vulnerable people and I am glad to hear the Minister of State say that Internet service providers of Ireland have a code of practice. I call on the Internet service providers to look at the websites mentioned and ensure minimum standards in respect of dealing with complaints.

Jan O'Sullivan (Limerick City, Labour)
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The information Deputy Mitchell O'Connor has put before the House is disturbing. Whatever methods can be used to ensure this information is not available to vulnerable young people should be taken. The point made about the difficulty in controlling sites coming from outside the country is a reality but we should do whatever we can. By raising the matter, Deputy Mitchell O'Connor has done a service.