Dáil Éireann - Volume 637 - 26 June, 2007
Adjournment Debate. - Mental Health Services.
Deputy Dan Neville Deputy Dan Neville
Deputy Dan Neville: I thank the Ceann Comhairle for selecting the issue of psychiatric services for debate. I feel honoured this is selected as the first matter for an Adjournment debate in the 30th Dáil.
I call on the Government and the Minister for Health and Children to reverse the decision to move the Central Mental Hospital to a site adjacent to the new prison at Thornton Hall in north Dublin. The Government must respect the human rights of people with mental illness. To locate a therapeutic facility for people with mental illness, many of whom have not committed a crime, beside a prison is stigmatising and discriminatory.
Not alone has this proposal been roundly rejected by the families and carers of Central Mental Hospital residents, voluntary organisations, the Mental Health Commission, the clinical director of the Central Mental Hospital and the Human Rights Commission, it also flies in the face of the core values and principles enshrined in the report on mental health services, A Vision for Change, which the Government proposed to accept as its policy.
Central to the treatment process for patients at the Central Mental Hospital is the aim to overcome the stigma arising from criminalisation which, in most cases, is an accidental effect of their mental illnesses. Other key objectives include the rehabilitation and reintegration of patients into mainstream mental health services when it is appropriate and safe to do so. None of these objectives would be helped by placing the Central Mental Hospital adjacent to a large, high-profile prison.
In his letter to the Taoiseach, the clinical director at the hospital stated, “the proposal is about as bad an idea as it is possible to imagine”. The director, Dr. Kennedy, is strongly critical of the fact that he was not included in plans to move the Central Mental Hospital and that he only learned of the developments through the media. There is an urgent need for a new hospital to replace the  Central Mental Hospital. This has been recognised for a number of years and should have been acted upon at a much earlier stage.
Dr. Kennedy is insistent that the new hospital should be located beside a general hospital. He stated 200 secure psychiatric beds are needed to end the situation in which prisons are used as psychiatric waiting rooms and are equivalent to accident and emergency department trolleys. The case for revisiting this decision made by the previous Government is compelling and I call on the Minister for Health and Children to do so immediately.
One of the key issues which must be dealt with in regard to mental illness is the challenge to de-stigmatise the one in four people who will suffer from such an illness during their lifetime. Those who suffer feel stigmatised by attitudes and views from a time when psychiatry was not as developed as it is today. Society must address its attitude to those who at some stage suffer a psychiatric illness. The siting of the Central Mental Hospital adjacent to the new prison complex reinforces the prejudices and misunderstandings that many people have about mental illness. The stereotyping of mentally ill patients will allow people to continue to discriminate against those who are suffering. We must rise above this approach. The Government must do so by reversing its decision on the siting of the Central Mental Hospital. It should give leadership in attempting to educate people who do not understand the pain of mental illness. Only then will people come forward and begin to admit the pain of their illness and seek solid mainstream help. Then and only then will we demand action from Government to acknowledge the scandal and neglect of the psychiatric services. Until there is a watershed in societal attitude many will hide their illness.
A recognition of the need to change the decision to locate the Central Mental Hospital would play a key role. Until it is acceptable to be mentally ill as it is to be physically ill we, as a society, will not begin to regard the reality of mental illness as part of our human existence. Until our everyday language becomes sensitised to the need to eliminate stigma we will not succeed in addressing the need of those who suffer a mental illness. Anyone can suffer a mental illness. Anyone can die by suicide.
Given the trenchant nature of objections raised by the clinical director of the Central Mental Hospital, Dr. Harry Kennedy, there is a compelling case for the new Government to revisit the decision to site the hospital at Thornton Hall. I urge the Minister and the Government to do so as a matter of urgency.
Deputy Brendan Smith Deputy Brendan Smith
Deputy Brendan Smith: I am replying to this Adjournment matter on behalf of  my colleague, the Minister for Health and Children, Deputy Harney. I thank Deputy Neville for raising this matter and acknowledge with him the importance of working to prevent suicide and improve mental health. This debate allows an opportunity to outline to the House the plans for the redevelopment of the Central Mental Hospital.
In May 2006, the Government approved the development of a new national forensic mental health facility at Thornton Hall, County Dublin. This decision was consistent with a recommendation outlined in A Vision for Change, the report of the expert group on mental health policy which recommended that the Central Mental Hospital should be replaced or remodelled to allow it to provide care and treatment in a modern, up-to-date, humane setting and the capacity of the Central Mental Hospital should be maximised.
The new hospital will be a separate capital project, independent of the prison complex. It will be managed and directed by the Health Service Executive. The new hospital will be built on its own campus and will retain its identity as a separate, therapeutic health facility. It will have a separate entrance and a different address to the prison complex. The cost of developing the new hospital will be met from the proceeds of the sale of the existing site of the Central Mental Hospital in Dundrum.
The Health Service Executive has established a project team to progress the redevelopment of the Central Mental Hospital. The design of the new hospital will take into account new standards for secure mental health facilities emerging in the UK and Canada. A new governance structure for the hospital is being finalised at present.
The decision to redevelop the Central Mental Hospital is a major step forward in the provision of quality care to prisoners with mental illness. There has been little or no structural change to the main part of the existing hospital since it opened in 1850. With the exception of a small, single-storey block built some 20 years ago, it remains essentially unchanged since it was built. Many of the elements of the building are unsuited to the provision of a modern forensic mental health service. Like other, unsuitable, older psychiatric hospitals, the closure of the existing facility in Dundrum is the correct decision. The Central Mental Hospital is the only centre in the State that provides treatment for mental illness in conditions of medium and maximum security. The majority of admissions to the Central Mental Hospital are from within the Prison Service.
Conditions within the Central Mental Hospital have greatly improved in recent years with increased staffing and an end to the practice of slopping out. Important safeguards for patients have also been introduced by the Criminal Law  (Insanity) Act 2006 and the Mental Health Act 2001. The Department of Health and Children and the Health Service Executive continue to strive to improve conditions at the existing facility.
However, the existing hospital facility must be replaced. The report of the Inspector of Mental Health Services stated that the building at the current site is unsuitable for providing an inpatient service. The Council of Europe Committee on the Prevention of Torture which visited the Central Mental Hospital in Dundrum earlier this year was also critical of the current facilities. Building a new hospital on a new site will open up a range of opportunities for the provision of modern treatment and recreational facilities. A purpose-built, modern facility, coupled with the required staffing, will offer the best treatment to people requiring forensic mental health services. I again thank the Deputy for raising this important issue.
Dáil Éireann 637 Adjournment Debate. Mental Health Services.