Address by Mr. Tim O´Malley T.D., Minister of State at the Department of Health and Children at the Launch of “Towards Recovery” New Principles of Good Practice in the Treatment of People with Schizophrenia

I was delighted to receive your invitation to launch “Towards Recovery”, a document which sets out Good Practice Guidelines in the treatment, care, rehabilitation and recovery of people diagnosed with schizophrenia and related mental health disorders. I welcome the opportunity to contribute to this event, which arises from a unique collaboration between Schizophrenia Ireland and Irish Psychiatric Association.

Schizophrenia has traditionally been a hidden illness that people were embarrassed to talk about. I am confident that the information contained in this publication will go a long way towards a better understanding of the problems surrounding schizophrenia and mental illness.

Unfortunately people´s experiences with mental healthcare services vary from exceptional standards of care and treatment to poor and less than satisfactory care. The report “the Stark Facts” published in April this year by the Irish Psychiatric Association highlighted marked inconsistencies in levels of service provision between the Health Boards. As a consequence these imbalances contribute to and sustain an uneven spread of strengths and deficiencies in service delivery. Both organisations represented here tonight are aiming to make delivery of mental healthcare more equitable and effective countrywide, and recognise that a collaborative approach represents the best way forward for the both the service user and the service provider.

Towards Recovery is a very welcome initiative aimed at achieving a collaborative position on the principles that will strengthen and guide the delivery of services for people with schizophrenia and their families. This document has been compiled after close collaboration and consultation between the two organisations. I trust that others will adopt it as a basis to guide future service developments in the knowledge that it represents the views of important contributors to this process.

We are all aware that good mental health is an integral component of general health and well being, allowing 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.

The need to involve all interested parties in the planning and delivery of services cannot be over emphasised. The Health Strategy speaks of empowerment as being part of its vision. The essential ingredient of empowerment is equality. With equality comes the possibility of partnership and participation and a move away from a focus on mental illness to a focus on wellness and recovery. In such a partnership, people become active participants in their own good health.

It is worth bearing in mind that the definition of health as defined by the World Health Organisation and chosen by the Department of Health and Children to underpin its Health Strategy is a “complete state of physical, mental and social well-being and not merely the absence of disease or infirmity”.

Schizophrenia Ireland plays a very significant role in the promotion of positive mental health. The organisation’s success is reflected in the establishment and growth of a network of support groups and services throughout the country, including counselling services and self-help groups for people suffering from schizophrenia who are managing their illness. This increase in the provision of services reflects the dynamic approach the organisation adopts to meeting identified needs. As an organisation representing people with schizophrenia and their carers, it is crucial that your hard work and particularly your awareness of the issues affecting your members is harnessed and utilised for the betterment of all concerned.

The key objective of the Irish Psychiatric Association is to raise awareness of the realities and challenges that the services pose to users and professionals alike and by doing so, to increase the focus on the need to provide and develop services for mental illness. The IPA logo “Working for professionals, working for patients,” reflects your commitment to continuing this task. Your collaboration with SI in drawing up these guidelines also reflects this commitment.

I would like to formally acknowledge and to thank both Schizophrenia Ireland and the Irish Psychiatric Association for publishing these guidelines and for your important work in educating public opinion about mental health issues in order to help create a more tolerant attitude to those who suffer from mental illness.

It is 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.

At national level, priority is being given to education awareness and to promoting a better understanding among the public of mental health issues. 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 well-being of a person. Increasingly, mental health is being recognised as a major challenge facing health services.

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.

Recent years have seen dramatic changes in both the concept and practice of mental health care delivery in this country. Enormous strides have been made and continue to be made in developing a service, which is comprehensive, community-based and integrated with other health services. The success and effectiveness of this policy is dependent on the active involvement of all interested organisations. The Government recognises the critical role played by the voluntary sector and the importance of health boards continuing to support and work closely with voluntary groups.

This shift in recent years in the delivery of services from predominantly hospital-based care to a service delivered in the community has been successful and undoubtedly the quality of care for persons with a mental illness has been enhanced by this development. The Government is fully committed to furthering this process. The mental health services, both statutory and voluntary, have met the challenges of change in recent years with enthusiasm and vigor and I am confident that the further development of our services, in a spirit of partnership between statutory and voluntary bodies, will be approached in the same positive manner. This is of particular importance with reference to the implementation of the provisions of the Mental Health Act, 2001 and the role of the Mental Health Commission.

The existing office of the Inspector of Mental Hospitals will be replaced next year with the office of the Inspector of Mental Health Services, who will be employed by the Commission. Both the Mental Health Commission and the Inspector will operate independently of the Minister for Health and Children and of the Department. This independent status will be crucial in driving the agenda for change and modernisation in the mental health services in the coming years.

The development of advocacy services in Ireland is a very recent occurrence, but it is another example of the significant improvements, which are taking place in the provision of mental health services. An advocate can be someone who can represent and defend the views, needs, wishes, worries and rights of individuals who do not feel able to cope themselves. Advocacy can also help service users to participate in and make decisions about their care and treatment. It can be a mechanism for changing attitudes of the public and media towards mental illness and those experiencing it.

The importance of advocacy is far reaching. Not only does it allow the patient concerned to express his or her concerns but it may also foster recovery by assisting patients to take control of their lives and their future. The power of self-help is a critical factor in any healing process. A sense of being able to share and discuss one’s fears and emotions within an understanding environment is invaluable and of tremendous solace at a time of crisis. That is the core of what advocacy is about. My Department supports these developments and is currently funding peer advocacy services, which are being developed, in the voluntary sector.

I know that my Department, the health boards, Schizophrenia Ireland and more recently, the Irish Psychiatric Association, have forged a positive working relationship over recent years and I believe that this relationship has led to greater openness, discussion and communication on how best to meet the needs of people with schizophrenia and other mental illness and their carers. In this connection, it is important that Ministers, in the Department of Health and Children and the health boards listen to what the members of organizations such as Schizophrenia Ireland and the Irish Psychiatric Association have to say to us about their experiences of the quality of mental health services and how this can be improved.

This is particularly relevant with regard to the commitment contained in the Health Strategy for the preparation of a national policy framework for the further modernisation of the mental health services, updating the 1984 policy document, Planning for the Future. An expert group is planned to facilitate this work and I hope to make an announcement in this regard in the very near future. While the precise composition of the working group has not yet been determined, it is anticipated that it will include representatives of service users. All areas of mental health policy and service provision will be examined in the course of the review and, where appropriate, additional research will be undertaken.

We have a common interest – the further development of our mental health service and I have no doubt that this partnership approach will equip us to meet this goal.

In conclusion, I would like to thank you for inviting me to speak at the launch of your guidelines and I hope that in the future these will be seen as a precursor to the development of more detailed standards of care for the provision of mental health care services throughout Ireland. I would also like to take this opportunity to wish Schizophrenia Ireland and the Irish Psychiatric Association continuing success in your important work.