Speeches

Opening Address by Mr. Tim O´Malley T.D., Minister of State at the Department of Health and Children at the Schizophrenia Ireland Biennial Conference in the Newpark Hotel, Kilkenny

Introduction

Thank you for your invitation to officially open Schizophrenia Irelands´ 13th Biennial Conference. I welcome the opportunity to contribute to this conference which will focus on ´Stigma´. An occasion such as this provides us all with an opportunity to acknowledge and recognise the importance and value of the work of Schizophrenia Ireland in responding to the needs of the vulnerable and disadvantaged in our society.

Schizophrenia has traditionally been a hidden illness that people were embarrassed to talk about. I am confident that events like this assist in breaking down barriers and go a long way towards a better understanding of the problems surrounding schizophrenia and mental illness.

Mental Illness and Stigma

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. A history of mental illness should never be a cause of discrimination, stigmatization or prejudice in any form, nor should it inhibit an individual’s right of access to training, education and employment.

We all know that good mental health is an integral component of general health and well-being 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 places on sufferers and their families.

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 mental health practices and highlighting the services that are available locally to people particularly in times of crises. It is in this area that the work of Schizophrenia Ireland is so important.

I want to take this opportunity to re-emphasise the 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 and the volunteers who give so willingly and generously of their time.

Schizophrenia Ireland

Schizophrenia Ireland has seen great changes in its own development since its foundation in 1975 to a point where it now 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 which include counselling services; a self-help group for people suffering from schizophrenia who are managing the illness; a drop-in centre for people suffering from schizophrenia or related mental illnesses, a free information service and specialised reference library.

This increase in the provision of services associated with Schizophrenia Ireland 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.

I am aware that Schizophrenia Ireland recently published its survey “A Question of Choice” conducted among people with enduring mental illness. This survey is significant in that it represents the views and experience of the recipients of our mental health services. From this survey it appears that the issue of providing written information to service users about their treatment, in a format and manner that they can understand, is of critical importance. What is also striking is that the majority of those surveyed (65%) were taking more than one medicine for their mental health problems.

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. As far back as 1998, he 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 since his 1998 Report was published.

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.

I would like to formally acknowledge and to thank Schizophrenia Ireland for publishing this survey and for its more general work in educating public opinion about mental illness. Your work has helped to create a more tolerant attitude to mental illness and has helped prepare the way for the significant changes that have taken place in our mental health services.

Development of Mental Health Services

We have seen major changes in the delivery of mental health services in Ireland in recent years. Enormous strides have been made and continue to be made in developing a service that is comprehensive, community-based and integrated with other health services. The success and effectiveness of this policy is dependent on the active involvement of voluntary organisations. We in Government recognise 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 the delivery of services from predominantly hospital-based care has been extremely successful and undoubtedly the quality of care for persons with a mental illness has been enhanced by this development. This government is fully committed to furthering this process and under the National Development Plan approximately €190m capital funding has been made available for the provision of acute psychiatric units attached to General Hospitals, in-patient child and adolescent facilities, units for the disturbed mentally ill, additional day care, mental health centres and community residences throughout the country.

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 Mental Health Act, 2001 and the Mental Health Commission.

The Mental Health Commission

As you are all aware the Mental Health Act, 2001 was signed into law in July 2001. The purpose of this Act is to provide a modern framework within which people who are mentally disordered and who need treatment or protection, either in their own interest or in the interest of others, can be cared for and treated. The Act also has a second purpose, which is to put in place mechanisms by which the standards of care and treatment in our mental health services can be monitored, inspected and regulated. The main vehicle for change will be the Mental Health Commission which was established on 5th April 2002 under the terms of this Act. I understand that Dr. John Owens, Chairman of the Mental Health Commission will be chairing a Plenary Session here tomorrow.

Future Developments

I know that my Department, the health boards and Schizophrenia Ireland 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 met the needs of people with schizophrenia and their carers. In this connection, it is important that we in the Department of Health and Children and the health boards listen to what the members of Schizophrenia Ireland have to say to us about their experiences of the quality of mental health services and how this can be improved.

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.

Conclusion

In conclusion, I would like once again to thank you for inviting me to speak at your conference which I am sure will be a great success. I would also like to take this opportunity to congratulate Schizophrenia Ireland on its many achievements to date and to wish you continuing success in your work.

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