23 December 2003

Press Statement from Irish College of Psychiatrists on
Hanly, Brennan and Prospectus

The Irish College of Psychiatrists is seeking a meeting with Minister Martin to discuss the many serious issues, which have emerged for Psychiatry in Ireland - based on the Hanly, Brennan and Prospectus reports. The request for a meeting follows a recent meeting of the Executive Meeting of the Irish College – where serious concerns were expressed about the future management and funding of Psychiatry..

The letter to Minister Martin went on to say, "We discussed the Health Reforms, including the three reports; Hanly, Brennan and Prospectus, and how they will impact on psychiatry / mental health and whether or not people with a mental illness will be better off when they are implemented. We established that there are a number of concerns and the Executive requested that you should be informed".

"Psychiatric services are mainly delivered in the community, while still requiring acute hospital beds, and long stay residential places with rehabilitation facilities. A/E units require the attendance of Psychiatrists as some mentally ill people need urgent attention, such as presenting with very disturbed behaviour, suicidal ideation and deliberate self-harm. This means that in examining the management structures of the Health Reform, Mental Health straddles the ‘pillars’ of the National Hospitals Office and Primary, Community and Continuing Care"

"We wish all mental health services to be included in the National Hospitals Office and we wish to continue to expand the number of acute units in major hospitals and establish day hospital / day programmes and out-patients at Local Hospitals (Hanly recommendations)".

"This would also mean that all specialities of mental health / psychiatry are included in the one pillar and are under the one Management, encouraging integration of services across the ages. This is a recommendation of the Working Party in Child and Adolescent Psychiatry – 2^nd Report"

"As psychiatry does not fall neatly into current management structures, it tends to get relegated into structures which do not reflect its function. The structures are developed with surgery and medicine in mind.

In the future with the introduction of the Health Reforms many of the other medical speciality services will be delivered in a similar fashion to that of psychiatric services at present. An example is the development of community paediatrics and the services for people with chronic illness such as diabetes. The development of well resourced Local Hospitals will speed up this process so that the delivery of these services will begin to resemble the delivery of psychiatric services"

The letter to the Minister also dealt with the serious and reducing funding of Psychiatry, "We also consider that one management system for mental health would hopefully mean a greater share of the health budget for all patients. Psychiatry has not received an increase this year and we believe this is totally unacceptable, given that the financial input fell from 9% to 7% of the health budget last year. I can emphatically say that this level of decrease is having serious implications for service delivery to our mostly vulnerable patients"