24 February 2004
Dr. Henry: I welcome the Minister to the House. We repeatedly read in the newspapers of cases before the courts in which no places of safety or treatment can be found for some of the most vulnerable people in our society. Children, adolescents and adults with serious conditions must be treated outside the country. Adults with mental illness, intellectual disorders or autism spectrum disorders or acquired brain injuries can be kept in prison or other places of detention because there are no proper facilities for them here. This is especially true if there are behavioural problems involved. I am sure there are many people who do not come before the courts who also have to leave the country to have their problems treated.
Children and adolescents are constantly before the courts with mental illness, intellectual disability, autism spectrum disorder and acquired brain disease. The reason they are there in the first place is that, as judges in the children's court have complained for years, there are no places of safety to which these children can be sent. I am sure the Minister is aware of a case which has repeatedly come before the courts in the last few weeks and was reported by Carl O'Brien in The Irish Times. A boy of 17, who was brain damaged in a car crash and has a mental age of seven to eight, had to be kept in Cloverhill Prison for about six weeks. While it was recognised that the prison officers did everything they could to facilitate the boy, allowing him to telephone his aunts and so on, it was not a suitable place to have a child with a condition such as this.
It is extraordinary that there is such a terrible lack of facilities in Ireland even though we have been aware of this problem for several years. People in the Republic of Ireland - adults and children - must be referred to Northern Ireland or our neighbouring island, or further abroad, for places in which they can be kept in safety and receive treatment if possible. People from the few institutions in which adolescents can be kept have asked me whether I can do more to obtain teaching for these children. Some of them need to keep up with schoolwork as best they can for when they recover from their mental illnesses. This must be costing the taxpayer an enormous amount of money. Would it not be better to build suitable facilities here and staff them? The problem has not started with the current Administration; it has been there for a long time. It is socially unacceptable to place people in institutions so far away from their families; if they are to be rehabilitated it is essential that they are as near to their families as possible.
I have not been able to obtain up-to-date figures of the cost per day of the UK National Health Service medium-secure units, but in 1998 the cost per day was £300 sterling, which adds up to more than £2,000 per week - about €3,000 - and I am sure it costs a great deal more now. At the time, a low-security unit cost about two thirds of this. I cannot understand why we cannot build our own units and recruit staff who will look after these patients, because they would be far better off near their families.
Recently the board of the National Disability Authority said its members would visit the worst hospital in the State. This is how the Inspector of Mental Hospitals described the Central Mental Hospital in his last report. The cost per day there is a few hundred euro. It would be much cheaper to rehabilitate that hospital - to rebuild it, if possible - and create other institutions especially for children so they will not need to be sent to institutions abroad, which is not helping the Irish taxpayer and is certainly not helping the recovery and rehabilitation of these people.
