David Norris (Independent)

I thank Senator Browne for sharing his time with me. This is an important opportunity for us to make statements and express views on the sensitive topic of mental health.

In the old days, people with mental difficulties were regarded as a pariah group. We should look with gratitude to that great figure, Dr. Jonathan Swift, Dean of St. Patrick's, who founded St. Patrick's Hospital. He made it clear there was such a thing as mental illness that was parallel to physical sickness and that no shame should attach to it. Prior to that, there was the Bedlam Hospital where people with mental illness were regarded as subhumans who could be taunted and provoked, who would foam at the mouth and entertain the visitors, a very callous view.

Despite changing attitudes, there is still a danger of stigmatisation, particularly an association between wickedness and crime and disease and illness. That is why I put the question of Thornton Hall at the forefront of my contribution. It is a move away from the situation we had with the Central Criminal Lunatic Asylum in Dundrum, a dreadful Dickensian place. I question the wisdom, however, of placing a mental hospital in the grounds of a prison because of the danger of association between the two institutions, both run by the State in the same grounds, which may form an association in the mind of the public. This is resented by those who access these services and I have been lobbied by both individuals and groups who feel this is very counterproductive, even though it may be efficient in terms of saving money. We must be careful we do not stigmatise this group of people.

We all have an interest in this because a report produced by Millward Brown makes the astonishing statement that nearly 70% of people in this country have some association with mental illness in respect of spouses, relatives and friends. This affects all of us.

There are novel approaches and I commend to the Minister of State the approach being taken in Trinity College. The Unilink initiative allows for people with a degree of mental illness or disability to enter third level education. It is marvellous to think that people are having their talents drawn out, that is what education really means. They receive help from mentors, staff and students, to cope with and manage their academic and social lives. This is being a good neighbour and I am proud that Trinity College has pioneered this and several other third level groups are doing the same. If we want to get people out into the community, this is a good way to do it.

Dr. Elizabeth Dunne, of the department of applied psychology in UCC, highlighted difficulties in a report published by the Mental Health Commission that surveyed people using the services. One of the main difficulties is time lag. If a person suffering from mental illness has a crisis, it is an immediate situation. One person indicated that he was very bad in May, asked to see a psychiatrist right away but was told he would have to wait until August.

A surprisingly high proportion of admissions were involuntary — 22% according to Dr. Dermot Walsh, former inspector of mental hospitals. It is, therefore, important to listen to the voice of those who have been through that experience. They recalled the experience as traumatic, involving inordinate force and, once they were in, they were suffocated by lack of privacy, exercise, fresh air and things to do if one does not smoke or watch television. We must take such criticism into account.

Young people are very vulnerable in a rapidly changing society in which gender roles are blurring and they can be easily confused. I support the move to provide an opportunity for young people to refer themselves without parental consent. Sometimes a young person in distress does not want the family involved because it may be the source of the trouble. Confidentiality is necessary. As Senator Browne pointed out, 11,000 present for self-harm in 2003 and we have a very high suicide rate.

We must act on what emerged in the recent survey on Irish attitudes to sexuality in The Irish Times. We do not have a proper education programme on the reality of sexuality, principally heterosexual but also with a component for young gay people who are subject to pressure. There is a multiplier in mental health statistics related to gay people.

There is also the problem of what happens to the young people who present themselves. There are only 20 beds in the State for young people and the system cannot cope. A doctor was quoted as saying that any time a colleague wants to admit a child, it is a huge issue for them because there are only 20 beds. She pointed out that the State has had five years to prepare for this. It is almost a cliché to cite cases involving the use of trolleys. In one case, however, a child was held for seven days on a trolley in an accident and emergency department. If a person in these circumstances has a pain, he or she will be able to put up with it and may even be distracted by all the fuss and bother taking place but this is the last thing a person with mental illness needs.

A further problem is the failure to implement certain aspects of the Planning for the Future document, published in 1984. The multidisciplinary team approach has still not been fully implemented 20 years after it was proposed. It must be completed.

Senator Browne referred to the poor physical environment in the mental health service. I found it heartening that, in parallel with criticism of places such as St. Ita's, in which we have all indulged for having peeling paint, blocked lavatories and poor conditions generally, the report pays tribute to nursing staff. I express my appreciation to the staff of mental health institutions who, in difficult circumstances and sometimes squalid conditions, provide wonderful standards of professionalism. It is for this reason I welcome the opportunity to give support to professional care workers in the area of mental health. The House will do all in its power to strengthen the hand of the Minister in securing access to extra funds and facilities and to ensure this vulnerable group of people is looked after.

Ireland has an unusually high rate of schizophrenia when placed in an international context. Several years ago, I was approached by Schizophrenia Ireland asking if it could link into Bloomsday. I agreed to its request and indicated I would provide any assistance I could because of James Joyce's daughter, Lucia. At that stage, Schizophrenia Ireland had not heard of Lucia Joyce but it subsequently designated 26 July Lucia Day. I will place on record the words of James Joyce who is often regarded as a cynical, distant man, a kind of remote, literary lion. In 1936 Joyce was spending money hand over fist to try to assist his daughter, Lucia. His friends started criticising him because of the expenditure. In a wonderful letter he wrote that he knew he was being criticised for spending "that precious metal", money, on trying to find a cure for "the most elusive disease known to man and unknown to medicine". Referring to his daughter, he added that if one were where she was and felt as she must, one would at least experience some hope if one knew one was neither abandoned nor forgotten. What a wonderful, humane letter and marvellous description of the mystery of mental illness, an illness known to man and, nowadays, only partially known to medicine.