Seanad Éireann - Volume 196 - 01 July, 2009

Music Therapy.

[604]  Senator Cecilia Keaveney: I thank the Cathaoirleach for allowing me to raise the important issue of music therapy in the House and I thank the Minister of State for staying on to answer the Adjournment debate. The Ministers of State, Deputies John Moloney and Jimmy Devins, and their predecessors will be very familiar with this matter because in September 2006 after a year’s research I completed a report, Defining Music Therapy, on behalf of the Joint Committee on Arts, Sports, Tourism, Community, Rural and Gaeltacht Affairs, of which I was Chairman at the time. Before I started the research I knew clearly that music therapy was very important but when I finished it I was shocked that although students can qualify as music therapists from the University of Limerick, the only location on the island of Ireland where students can so qualify, there is no professional recognition in this country for the profession of music therapist. On the other hand, if students leave the University of Limerick and go to Northern Ireland, they will be treated in the same fashion as occupational, speech and language therapists and physiotherapists. They are not physical therapists or “musical” therapists but are in the same category as all the recognised professions in our health sector.

In the context of our current economic situation there are many people who might not have admitted to or perhaps might not have had mental health difficulties in the past. There is a move to try to deal with mental health in a new way and I commend Senator Frances Fitzgerald, who is present, and Deputy Chris Andrews, who were involved today in the inauguration of a special cross-party, cross-sectoral approach to the issue of mental health. That shows there is an issue that must be addressed.

I have been dealing with this matter since 2006 in trying to have that professional recognition established. I commend the Ministers of State who have been in charge of this area because they have made efforts to ensure that we at least know the path and have been cogent in our arguments. I recognise Professor Jane Edwards of University of Limerick on the magnificent work being done there. At different times, one can hear her on RTE explaining that work.

Music therapy plays a central role in preventing repetitive behaviour and improving speech in autistic children, in returning speech to stroke victims and making Alzheimer’s disease patients comfortable, as music is one of the only senses that transcends both sides of the brain. While people with Alzheimer’s disease might not get better because of music therapy, they will have a better quality of life.

Everything in health must be backed up by facts and statistics. Previously, one could state that something was anecdotally this or that, but there are now facts to support the claim that music therapy works, and it should be central to any theme. In every other English language health system, it is central. I will not bore anyone with facts, but I will cite some of the comments made by people working in the system. The majority of symptoms in children and adults, including attention deficit disorder, learning disabilities, autism, obsessive compulsive disorder, depression, anxiety, chronic pain and many more, are the direct result of electrical imbalances in the brain. Many environmental factors can produce such an imbalance of electrical activity and function of both sides of the brain. These have been documented as an increase of activity on one side or a decrease of activity on the other side. Research has shown that the side of the brain that is most problematic is most often the side that is understimulated. Brain balance music as a stimulant can be a powerful tool in achieving that balance.

[605]I am not discussing someone feeling better because I played a guitar or sang a song. This is a clinical intervention that uses music to bring people out of themselves, to discover problems and to work in a multidisciplinary team to ensure that the patient can be clinically assessed and given a programme and can come out the other side as a functional person.

Dr. Oliver Sacks, who is relatively famous for writing many books from which a number of films were made, including “Awakenings”, described music therapy. He is claimed to be superb in that he surveys the use of music as a therapy, how singing can transform the brain’s right hemisphere into an efficient linguistic organ when the left has been knocked out by a stroke and how rhythmic music can unlock the movements of sufferers of Parkinson’s disease by imposing an external beat on their frozen internal clocks. Since music memory seems to survive longer than——

  An Cathaoirleach: The Senator’s time is up.

  Senator Cecilia Keaveney: ——any other kind, songs with autobiographical associations reawaken the sense of self in dementia sufferers. It is sad that these facts are not recognised in Ireland whereas they are recognised internationally. I hope that the House will be told of further moves in respect of the professional recognition of music therapy.

  Deputy Michael Finneran: I am taking this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I am pleased to have this opportunity to address the issues raised by Senator Keaveney. I emphasise the Government’s steadfast commitment to people with disabilities and to the national disability strategy and its long-term goals and objectives, which we will continue to pursue in the coming years in partnership with all the key stakeholders. The co-ordination and planning of services to meet the needs of people with disabilities form a central tenet of the strategy. A critical element of such co-ordination and planning is the requirement to provide financial support for the development and implementation of services.

Significant investment has taken place in mental health services in line with the report, A Vision for Change. This includes the development of community mental health teams and a significant expansion of child and adolescent mental health teams, which has led to an increase in the number of psychiatrists and therapists employed. The Health Service Executive, HSE, aims to provide access to therapy services that are of a high quality, sustainable and orientated towards optimal outcome. A range of therapeutic supports is provided for people with mental health difficulties, people with disabilities, including autism, and other service users. The provision of such therapies depends upon the assessed needs of an individual. Likewise, significant funding has been allocated in recent years under the multi-annual investment programme, which facilitated the prioritisation of therapy services in specialist disability services. Since 2005, there has been an increase of approximately 397 whole-time equivalents in the level of multidisciplinary supports, including speech and language therapists, occupational therapists and physiotherapists being employed in specialist disability services.

The Disability Act 2005, which commenced on 1 June 2007 for children aged five years or younger, sets out a legal footing for the assessment of children who have the right to have their needs assessed within specific timelines. The Act also gives people with disabilities, including autism, who meet the criteria set out in the Act the right to a statement from the HSE setting out the services that will be provided to meet the needs identified in the assessment report.

[606]The HSE recognises the importance of providing therapy services and the significance of a multidisciplinary approach in their provision. While the HSE recognises the benefits of specific therapies such as music therapy, this form of therapy are not among the range of therapies that are frequently selected to meet the assessed needs of individuals.

As the Senator is aware, music, drama, art and dance are collectively known as creative arts therapies. Creative arts therapists work on an ad hoc basis in a variety of health care and educational settings. There is no formal grade of creative arts therapist within the health service. The current professional status of such grades has been the subject of ongoing discussions between the Department of Health and Children and the HSE. A business case regarding the establishment of a grade of creative arts therapist was submitted by the HSE to the Department of Health and Children last year. It was examined and the Department requested further detailed clarification from the national HR directorate of the HSE to quantify and document fully the level of service being provided by persons within the health service currently undertaking work similar to that of the creative arts therapist. The detailed information requested is being awaited and, as such, the process has yet to be finalised.

However, as the Senator is aware, the significant demands on all public services are increasing and the priority for our health services in respect of disability services will be the provision of clinical therapies. This does not detract from the importance of such therapies as music, art and drama to an individual’s quality of life, but it signals the need for prioritisation.

I reaffirm the Government’s commitment to people with disabilities, the national disability strategy and its long-term goals and objectives, which we will continue to pursue in the coming years in partnership with all the key stakeholders.

  Senator Cecilia Keaveney: May I comment?

  An Cathaoirleach: The Senator may ask a brief question.

  Senator Cecilia Keaveney: To counter the argument that music therapy is not frequently used, professionals cannot be kept in Ireland if music therapy is not recognised as they will not be paid amounts equivalent to that paid elsewhere. There are also few full-time jobs. Does the Minister of State agree that we should prioritise music therapy further? Milford Hospice in Limerick is a good example of it working well.

  Deputy Michael Finneran: The HSE’s further submissions to the Department are still being processed. If we await them, we might have more information on the matter.