The number of people with psychiatric illness being involuntarily committed to mental hospitals in the Republic is "embarrassingly high" compared to other countries, the chairman of the Mental Health Commission said yesterday.
Dr John Owens said admission rates here averaged 100 for every 100,000 people over the age of 16 compared to 80 per 100,000 in Northern Ireland and 25 per 100,000 in Italy.
The rates in the Republic had to be brought down, he said, before confirming that some 2,667 people were admitted to psychiatric hospitals against their will in the Republic in 2001. The figure for 2002 was similar, he said.
Even within the State the rates of admission varied, he said, with higher numbers of involuntary admissions in the west and northwest than in the north-east and east for example. There was no "obvious reason" for this other than variations in "clinical practice", he said.
The commission will be discussing with individual clinicians why their committal rates are higher than in other areas.
Committals, he said, could also be brought down by establishing good community mental health services which would detect illness early and treat it before it got severe. "I would hope certification rates would come down to 70 per 100,000 within the next couple of years," he added.
By the middle of next year the commission hopes to have established a number of mental health tribunals which will review automatically after 21 days all decisions to detain patients against their will. People committed for shorter periods who feel they were unfairly committed also have a right to go to the tribunals after 21 days.
However, the work of the commission, set up a year ago to encourage the establishment of high standards in the delivery of mental health services and to protect the interests of people detained in psychiatric units, is already being hampered by lack of funding.
Dr Owens said he had hoped an Inspectorate of Mental Health Services would already have been appointed by the commission but the appointment had been delayed by funding problems.
He estimates the tribunals the commission wants to set up to review involuntary committals will cost up to €12 million a year. "The commission are in constant contact with the Department of Health about the urgency of this situation and I would hope that its urgency would be recognised and answered."
He also criticised the drop in funding for mental health services in the State in general. Spending had decreased from 10.6 per cent of the health budget in 1990 to 6.8 per cent in 2003. Given that a quarter of the population may be affected by a mental health disorder it was essential that "an equitable share" of the national health budget was allocated to mental health services, he said.
Furthermore, he called for a more equitable distribution of resources for mental health services within the State. "Funding for different regions of the country is largely a reflection of the historical location of mental hospitals, with little account being taken of the need to increase funding in line with major population changes." The budget for some regions is five times more than others.
Dr Owens also expressed concern about the "forced medication approach" to treatment of people with mental illness and said tackling this and the urgent need to provide adequate psychiatric services for people with learning disabilities who suffer from mental illness would be priorities for the coming year.