Address by Mr. Tim O´Malley T.D., Minister for State at the Department of Health and Children at the Launch of Mental Health Ireland´s Information Leaflets

I would like to thank Mental Health Ireland (MHI) for inviting me here today to launch their Information leaflets. An occasion such as this provides us all with an opportunity to acknowledge and recognise the importance and value of the work of Mental Health Ireland in responding to the needs of the vulnerable in our society.

We are all aware that good mental health is an integral component of general health and wellbeing, which allows a person to realise his or her abilities. With a balanced mental disposition, one is more effective in coping with the stresses of life, can work productively and fruitfully and is better able to make a positive contribution to his or her community. Thankfully, society now recognises more fully the burden that mental illness place on sufferers and their families.

In Ireland, people with a mental illness were excluded, for many years, from full participation in community life as a result of widespread stigmatisation of mental illness.

While researchers and clinicians have made important advances in reducing suffering and accompanying disability, the battle against the stigma and social exclusion caused by mental illness is ongoing. I am very conscious of the importance of fostering an awareness of positive mental health while also highlighting the services that are available locally to people, particularly in times of crisis.

At National level, priority is being given to education awareness and to promoting a better understanding among the public of mental health issues.

Mental health promotion is a very broad concept as it emphasises the promotion of the psychological health and well being of individuals, families and communities. I see it as a key task of the health services not just to treat mental illness but more importantly, using the principles of health promotion, to try and improve the mental health of the population at large.

There is a growing awareness and concern throughout the country about mental health matters and the National Health Promotion Strategy, 2000-2005, in conjunction with the health strategy “Quality and Fairness”, sees mental health as being equally as important as physical health in the overall wellbeing of a person.

The promotion of positive mental health will contribute significantly to combating the ignorance and stigma, which often surrounds mental illness. Better understanding of mental illness encourages people to access professional help sooner rather than later and this facilitates early recovery. Eventually, with time and education, the stigma may fade further away, allowing sufferers and their families to participate fully in society in every way.

I am particularly pleased to note that one of the leaflets “Mental Health and Young People” is specifically aimed at young people. I am very conscious of the importance of promoting both positive mental health and an appreciation of mental health issues among young people. Adolescence is traditionally viewed as a time of profound change when young people make the transition to adult status. This transition is not easy and for many young people is accompanied by levels of self-doubt, fear and stress. An important aspect of coping with this change will be to promote self-esteem and self-confidence and to ensure that all young people develop personal and social skills. Children and young people need support in gaining control over their lives and coping with their problems.

Another important leaflet being launched is – “Facts you should know about the medicines you take”. This will be extremely helpful to all patients as the more knowledge they have about their medication the more they become team players in their own mental health care. I know from recent surveys that a high percentage of patients are taking more than one type of medication for their mental health problems. As a Pharmacist, this is an issue which is of particular concern to me and which has been highlighted in the past by the Inspector of Mental Hospitals. He has expressed concerns in his Annual Report in relation to the prescribing of medication and in particular the widespread prevalence of polypharmacy; that is, the simultaneous prescribing of large numbers of drugs. Traditionally, polypharmacy has a negative connotation, implying an inappropriate or irrational use of multiple medications.

While the use of multiple medications can sometimes be an effective clinical intervention, the degree of risk and benefit associated with polypharmacy varies depending on the medications used and of course the characteristics of the patient concerned. In his 1998 Report the Inspector stated that a more organised approach to the prescribing of drugs was required in many mental health services. However, it has been noted by the Inspector in subsequent reports that this situation has improved in many services.

What is clear to me is that the question of the concurrent use of multiple medications in a single patient is still an important one and needs to be opened up for discussion among clinicians and service users. I would envisage that this may be an area in which the new Mental Health Commission could play a role. Their principal function, as defined in the Mental Health Act, is to promote, encourage and foster the establishment and maintenance of high standards and good practices in the delivery of mental health services. It would therefore be open to the Commission to investigate this issue if it so wished and I would hope that it will do so, in due course.

Of particular interest to all of us are the leaflets about “Stress and Mental Health in the Workplace”. People in all walks of life experience stress. It is not limited to the top executives or senior managers. Learning to recognise and cope with stress is vital to a person’s wellbeing. Stress can manifest itself in many forms, such as headaches, insomnia, depression, lethargy, under-performance, absenteeism, job dissatisfaction. It can be difficult for people to disassociate themselves from problems at home and thus domestic pressures can affect work performance. It can be equally difficult to leave work problems behind at the workplace at the end of the day.

It is clear, that for many people, a job can be more than a source of income. It can also be a source of ill health and unhappiness. The workplace has long been identified as a prime source of stress that can, in turn, result in ill-health. An increasing number of people are taking time off work with stress related conditions. It is important that stress in the workplace is addressed not only because of the cost implications for employers, which of course are significant, but also because failure to address the issue will impact negatively on the mental well-being of staff.

Health at work covers a wide range of issues from a basic concern with health and safety through to lifestyle management. Controlling stress in the workplace is no more optional than the control of any other hazards. Some stress in any job is inevitable; it is a fact of working life. It is however, important that excessive stress be dealt with. Identifying the problem, in itself, is not sufficient. A systematic approach to preventing stress in the workplace must be adopted.

I would like to formally acknowledge and to thank Mental Health Ireland for its work in educating public opinion about mental illness. This has helped to create a more tolerant attitude to mental illness and has helped prepare the way for the significant changes which have taken place in our mental health services. I also want to take this opportunity to re-emphasise my Government’s commitment to encourage, in any way it can, the activities of our many voluntary organisations both at national and local level. In today’s busy world the recruitment of volunteers presents a major challenge to all voluntary organisations as people, especially young people, have so many demands on their time. It is important that the public be made aware of the immense work done by voluntary organizations such as Mental Health Ireland and the volunteers who give so willingly and generously of their time.

The future of our mental health services holds many challenges. I am certain however, that the way forward can be made easier and more productive through the continued co-operation of both the state and voluntary organisations and the exchange of information, which is exemplified by the launching of these information leaflets.