Mental health services are also in disarray

Protection for mentally ill patients who are admitted to psychiatric hospitals against their will is still unavailable because of a dispute with consultant psychiatrists about resources.

Independent mental health tribunals were to provide, for the first time, a case-by-case assessment of each involuntary admission by a panel of consultants within 21 days of admittance.

They were due to be established last year but a dispute arose because of psychiatrists' concerns that the time spent on the tribunals would reduce the amount of time available for their private patients and affect their income.

Every year, 2,600 patients are involuntarily admitted to psychiatric hospitals or units, according to figures from the Mental Health Commission.

"We are disappointed at the delay in establishing the tribunals," said Dr John Owens of the Mental Health Commission.

"We are in negotiation with the consultants and the issue will be resolved, hopefully sooner rather than later. For them it is a question of resources, for us it is a question of basic human rights for people who are mentally ill. Every other country has an independent review system for involuntary admissions. We need to decide where our priorities lie."

In a report launched on 10 March by the Commission into mental health research, Dr Fiona Keogh said that one in every four persons is affected by a mental illness. Mental disorders are ranked as the second most common disease in the world, with a higher incidence than AIDS, malaria and TB combined.

The economic cost of adult mental illness in England is estimated at £9 billion, calculated by assessing the cost of treatment and the number of working days lost through illness per year. In Northern Ireland, the estimated cost is £3 billion. There are no figures available for the Republic. The Mental Health Commission has commissioned NUI Galway to undertake a study on this, due to begin shortly.

The Commission is critical of the lack of priority given to mental health research in Ireland and says that better knowledge about mental health and what actually works leads to better services and increased value for money.

Although the Government launched the Health Research Strategy in 2001, most of the recommendations have still not been implemented. "(There is) a vacuum in terms of direction, priority setting and funding for health research. There is no national mental health research strategy. There is little established research capacity for carrying out mental health research," the report entitled Research Strategy for the Mental Health Commission states.

Research into mental health constitutes only a very small percentage of the overall health research budget, according to Fiona Keogh, the author of the report.

Of the 170 research project grants awarded by the Health Research Board from 2001 to 2003, only four (two per cent) were under the heading "Mental Health and Clinical Neurology". Under the heading "Health Services Research and Practice Based Research", 16 grants were awarded. One was in the mental health area.

The Commission has proposed a four-point action plan to promote mental health research: build up the research infrastructure through access to expertise, computer and library facilities, and research funds; establish a network where researchers can link up through the internet and a database to record abstracts of all mental health research conducted; support the establishment of mental health research centres; and establish a Mental Health Research Committee which will advise the Commission on research that has been done and research that needs to take place.

Hilary Curley