John Minihan (Progressive Democrats)

I join previous speakers in welcoming the Minister of State to the House to allow us the opportunity to make statements on the very welcome report from the National Disability Authority. It is important that we debate in this House reports which deal with marginalised groups within our society. With previous speakers I compliment those people associated with the compilation of the report.

By their nature, reports will always bring up positives and negatives. We should reflect on reports in order to see if we are going in the right direction, to note where inadequacies have been highlighted and to see how we can make improvements. In the area of mental health, and the general health services, the fairest assessment anyone can make is that there will always be more to do. It will be the same in 20 years time and was the same 20 years ago.

We must acknowledge our progress in the mental health area over the past 40 years. There has been an opening up of something previously hidden in our society, and that is welcome. This is a two-facet operation. The health providers have a responsibility not to hide behind walls and deal with mental health and intellectual disabilities in that environment. There is also a responsibility among the service providers and public representatives to educate the broader community and society in the needs and advances. We must acknowledge the advances made in diagnostic approaches to mental illness. In the past, the mentally ill were treated as a single body of people and put into mental institutions. We have now broken down the area of mental illness and moved forward in areas such as that of intellectual disability, a term not used 30 years ago.

I acknowledge the funding increase noted in the report. I pay tribute to the Minister for Health and Children for the manner in which he has approached his responsibilities, particularly in securing the additional €25 million required to move to the next level. Having attended public meetings with the Minister, I have seen the way he has put forward the principle of the patient being the most important person, and has emphasised that the services are directed towards the patient and his or her interest. I also acknowledge the relationship he has developed with the various societies and organisations with which he has met.

I will comment briefly on the area of residential care, particularly care in the community. If we are to make progress in removing the stigma of mental illness and intellectual disability, we must embrace an association between patients, their families, the relevant organisations and the community at large. This has been a successful approach. Reducing the number of patients in institutional care and increasing residential care in the community is a positive step. Unfortunately, however, there have been examples of communities being somewhat reluctant to embrace this approach. While this is to be regretted, our approach to residential care in the community must run parallel to our responsibility to educate the broader community as part of our health strategy.

We should also acknowledge the dramatic increase in intensive placements, the expansion of support services in the residential area and the provision of day centres. In particular, we must acknowledge the support required by families for respite in all areas of illness. On an occasion such as this debate, we should acknowledge the great service provided by families, carers and voluntary organisations.

We cannot expect the traditional State-provided services to work alone in the context of a broad area such as mental illness. We must work in partnership with voluntary organisations rather than regarding them as the enemy. We all have the same objective and these organisations have something to contribute. Working in partnership with them will be the proper way to move forward in addressing this issue.

I will comment briefly on the establishment of the Mental Health Commission and the inspectorate. The inspectorate is welcome and its annual reports on mental health institutions will afford us the opportunity to set targets, meet shortfalls and address the issues highlighted in the reports.

It is important that everyone plays a role in developing and addressing the societal changes required if we are to place on a sound footing a proper mental health strategy. Under the leadership of the Minister, we are going about this in the proper way. I congratulate everyone involved in compiling the report, acknowledge its positive aspects and hope we can address the genuine concerns raised.

While there is no doubt that mental health services stood still for a period, since the late 1980s we have made improvements which must be acknowledged, although there will always be more to do in this area. I wish the Minister well in his responsibilities in this regard. I am sure we will continue to see growth and advances in the provision of services in the coming years and, I hope, greater understanding and acceptance by the general population of requirements in the area of mental health. I also hope the approach that medication can solve everything will decline and education of everyone will be enhanced.