Seanad debates
Wednesday, 19 November 2003
Adjournment Matters. - Drug Treatment Services.
10:30 am
Ulick Burke (Fine Gael)
Link to this: Individually | In context
I welcome the Minister of State to the House. On 1 October 2003, the Western Health Board decided to discontinue and close the residential drug addiction and alcoholic centre associated with St. Brigid's Hospital in Ballinasloe. This service was established as far back as 1982. Since then it has served the wider catchment area of the eastern portion of the Western Health Board, in east Galway and adjoining areas. The health board's decision came as a severe blow to the many people who had worked there and built up the service as well as to the patients who had benefited enormously over the years and who had been rehabilitated through the centre's professionalism. Given that St. Brigid's Hospital is currently being replaced and is expected to be sold, probably in the near future, I ask that the Department provide funding from the resources made available following the sale of the hospital and its adjoining property to construct a purpose-built unit adjacent to or within the complex of Portiuncula Hospital, Ballinasloe. This will provide a continuation of services.
It is unfair that those who are piloting the project and insisting on the closure of the facility at St. Brigid's Hospital have misrepresented the situation. Mistruths have emanated from them with regard to the intake of the in-patient service at the centre. It is not true to say there have been no referrals there for the last couple of months, with the result that there is no need for an in-patient service. That is unfair to those who have worked at the centre. The figures for the period 1 October 2001 to 30 September 2002 show a total intake of 92 people, 58 male and 34 female. Some 70 were first referrals, 46 male and 24 female.
Some would argue that the best approach is to use a community service on an out-patient basis because of the numbers of counsellors and other support staff that would be available in the community at large, in Portumna, Loughrea, Mountbellew and the surrounding areas as well as in Ballinasloe. However, out-patient care does not always suit everyone who may wish to avail of the professional services on offer. In-patient care is far more appropriate because of the particular background, family circumstances and a range of other social and economic factors that might be pressing on a particular patient. The model at this centre over the years is similar the one currently available in St. John of God's and the Rutland Centre.
If the service continues to remain closed many people will be forced into private accommodation which they cannot afford. The centre at Ballinasloe was unique in that it catered for people from a wide variety of backgrounds, including those with a high academic achievement as well as the more socially disadvantaged. Many private institutions would not necessarily have such a mix.
The closure of the facility came as a shock to those who had benefited from the centre and who found they now had to avail of the community service. Many of those who were in-patients have abandoned the service, which is regrettable.
It is important for the Minister of State to refer to the reports. One is a position paper on substance abuse from the east Galway mental health service. It was compiled by professionals working at the coalface who knew not only their patients but how they should be treated. They say there are many and varied reasons why a community treatment programme is not appropriate for some individuals. The literature and the various policy documents are loud in acknowledging this. The report, Planning for the Future, recommends that in addition to a fully developed comprehensive community treatment programme, beds should be provided per sector for in-patient treatment for those suffering from substance abuse. It states: "Accordingly, we strongly recommend, as we are only at the embryonic stage of a comprehensive community programme, the continued provision of our existing nine-bedded in-service programme in Ballinasloe." These nine beds are, according to Planning for the Future, a minimum requirement. According to the second guideline of Planning for the Future, the service should have access to two to three beds for clients unable to attend out-patient services or who, perhaps, live long distances away as well as for social reasons.
The national drugs strategy states that services should be organised on the basis of overseeing the development of comprehensive, residential treatment models incorporating detox, intervention, pre-treatment counselling, motivational work, therapeutic treatment and rehabilitation. All the reports at the disposal of the Minister of State, Deputy Tim O'Malley, clearly and distinctly outline the need for the retention of this service that was established on a pilot scheme in 1982. Since then, it has been of tremendous benefit to many people. It is important that the Minister of State indicates the provision of funding for the re-establishment of this service on a residential basis in the Portiuncula Hospital complex. The Mental Health Act—
John Dardis (Progressive Democrats)
Link to this: Individually | In context
The Senator must conclude. He has had a great deal of latitude.
Ulick Burke (Fine Gael)
Link to this: Individually | In context
The Act necessitates the separation of services. It will no longer be possible for patients with alcohol problems to be referred to a psychiatric institution. It is important that alcoholism is recognised as a disease that should be treated in the context of general health rather then psychiatric services. On behalf of those people who have worked in the service for so long, I look forward to hearing the Minister of State indicate his intention to adequately resource and finance a residential service in Ballinasloe.
Tim O'Malley (Limerick East, Progressive Democrats)
Link to this: Individually | In context
I thank Senator Ulick Burke for raising this matter on the Adjournment.
National policy on the treatment of alcohol abuse stipulates that the emphasis in the management of alcohol related problems should be on community-based intervention rather than on specialist in-patient treatment. Health boards already provide and continue to develop a range of comprehensive community-based support services appropriate to the needs of persons affected by alcohol abuse. These services include family support and community, medical and social services in the management of the problem. Health boards are also considering ways in which services provided by voluntary and-or private facilities might integrate with the health boards' services. A number of boards have made local arrangements to enable access to specialist in-patient treatment in the small number of cases where the need arises.
The main therapeutic tools in the treatment of alcohol dependence are psychotherapy, counselling, family and marital therapy, either individually or in group settings. As alcohol related problems occur, in many instances, in local and family settings, the community-based response can be direct and early, thereby reducing the associated levels of physical, psychological and social problems. Research supports this model of delivery as being just as effective as in-patient treatment.
Against this background, the alcohol treatment unit at St. Brigid's Hospital, Ballinasloe, County Galway, officially ceased operation as a residential unit on 1 October 2003. The closure of the alcohol treatment unit has taken place in the context of the Western Health Board's overall development strategy for the modernisation and enhancement of addiction services in the region. The lack of referrals to the residential addiction unit over recent months was also a factor in the decision to reorganise the service.
Tim O'Malley (Limerick East, Progressive Democrats)
Link to this: Individually | In context
The decision to cease residential services was taken after widespread consultation with stakeholders through the forum of the east Galway future shape group. This decision represents an improvement in the addiction services of the Western Health Board as there are now 11 addiction counsellors in the east Galway service where heretofore there were three. The expanded service provided is locally based to the people in the following towns and regions: Ballinasloe-Mountbellew, Gort-Portumna, Tuam-Headford and Loughrea-Athenry.
People who present to locally-based services with addictions are assessed and a variety of treatment options offered. Where it is clinically determined that a person requires residential treatment for his or her alcohol problems, suitable arrangements will be made and funded by the Western Health Board.
I am aware of the emotion within the community that the closure of the unit has generated. I also understand that there has been some misinformation. I am assured that the Western Health Board—
Tim O'Malley (Limerick East, Progressive Democrats)
Link to this: Individually | In context
—continues to be committed to providing a service that is evidence-based best practice.
The Seanad adjourned at 7.55 p.m. until 10.30a.m. on Thursday, 20 November 2003.