Geraldine Feeney (Fianna Fail)

I welcome the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, and thank him for his regular attendance here which we appreciate. I am delighted to have an opportunity to speak about the second annual report of the Mental Health Commission. I commend the hard work of its chairman, Dr. John Owens, and Ms Bríd Clarke, its chief executive officer.

It is widely acknowledged that there have been significant advances and much needed change in the delivery of mental health services over the past ten years. I am concerned about child and adolescent psychiatry and was interested to read, on page 35 of the report, that estimates suggest that services for this group require in the region of 120 beds nationally; for those with intellectual disability, some 220 beds are required while 30 beds are needed for those with eating disorders. Those estimates may even be low. There is an urgent need to put in place a planning exercise to ensure those beds are available.

Senator Henry referred to the study reported in The Irish Times on Tuesday. I was interested to read that Clonmel was selected because it had a good mix of urban and rural population. The study covered 4,000 children under the age of 18 and as young as 18 months. I was somewhat shocked to read that 17% of adolescents suffer from a significant form of mental illness.

In preparing for this debate I spoke to a child psychiatrist who said those figures were already known. I was surprised to learn that 12% of pre-school children are suffering, as are 11% of those in national school and 24% in secondary school. That will be the major problem in future for all the reasons outlined this morning. Adolescents are the most vulnerable group, whether due to their social life, with excessive drinking, exposure to drugs or bullying in school. However, whatever the cause, 24% is much too high a figure.

Of the 17% established as having serious mental health problems, 8% will do well because they have access to good primary care services. These services can cater for them only where there is a good general practice service, counsellors in schools and where community care services and social workers are adequate and working. Sadly, the remaining 9%, who should receive treatment, do not; only 1.5% of that 9% see child psychiatrists.

I am pleased that in the recent Cabinet changes the Minister of State retained the brief he has held since 2002 because continuity will ensure the delivery of the best services. The planning committee he set up is considering developing units and inpatient beds for child and adolescent psychiatry. Money has been earmarked for this area. When will those units in Cork, Dublin, the mid-west, and possibly one other, be ready?

I know the pain a parent, or parents, undergo when they have a child or adolescent suffering from mental illness. Before Christmas I raised this issue on the Order of Business because a tragic story about a 14 year old boy had come to my attention. He needed hospital care but no hospital was willing to take him. He was eventually admitted to one of the main psychiatric hospitals in Dublin. However, while he was being admitted he disappeared and, sadly, a few hours later he was found dead. Nobody will ever know what his parents must be going through.

There is another case where a 13 year old needs to be hospitalised but because of the case before Christmas psychiatric hospitals are afraid to admit adolescent patients for whom they do not have any beds.

I am aware the Minister is working hard in this area and that he is a caring person. Money needs to be invested in child adolescent psychiatry services. We need to bring beds on stream for the treatment of such children.

Representatives from Aware appeared before the Oireachtas Joint Committee on Health and Children three or four weeks ago. We discussed community care settings and the wonderful work being done. Those settings have proved to be far more beneficial than the big old hospital setting. The representatives brought to our attention that patients were being brought out of the big institutions into a smaller institution, in that they are being housed. The Minister of State should ensure that such patients are allowed to enjoy independent living because the representatives said they are not being allowed the independence the community setting was established to give them.

I wish to comment on acute units. When I was a member of the Medical Council I had the opportunity three years ago to visit an acute unit, the Jonathan Swift clinic, that is attached to Tallaght Hospital but which was previously based in St. James's Hospital. That unit is a blueprint for the way forward. It is a beautiful unit. It took a while to get used to the level of security needed in an acute unit. Doors automatically lock when one goes through them and that is a necessary safety provision for a person suffering from a mental illness. The unit is a modern building with bright painted walls. There is no sign of the drudgery to which we would have been accustomed in the old mental institutions. There were flowers in the unit, beautiful paintings on the walls and the soft furnishings were comfortable. It was almost like a home from home. Is that not the way forward? The more acute units of that style we have, the better.

I am disappointed my colleague, Senator Browne, has left the Chamber. He should not read anything into what happened on this morning's Order of Business. I was not in the Chamber for it as I was preparing for this debate. Regardless of which Members on this side of the House are members of Fianna Fáil or the Progressive Democrats, we would have no difficulty in defending the Tánaiste or any other Minister. We do not believe the Tánaiste needed defending this morning and perhaps that is the reason there was silence on this side of the House. We were allowing Opposition members to have their say.