Denying cannabis link to mental illness is ‘like arguing earth is flat’

Denying the links between cannabis and mental illness is like arguing the earth is flat, one of the country’s leading psychiatrists has suggested.

Delivering the Irish Medical Organisation's annual Doolin lecture on Saturday Dr Brendan Kelly, professor of psychiatry at Trinity College Dublin and consultant psychiatric to Tallaght Hospital said there was no doubt that cannabis was bad for mental health.

“The more cannabis you smoke, the more chance of a severe mental illness. It is as simple as that. And people who deny this link, are really akin to denying smoking causes cancer, who say climate change isn’t happening, who say the earth is flat and stuff like this. And they are valid view points but they are also wrong.”

Prof Kelly said while cannabis was bad for health, it was a separate question to ask what should be done about it.

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“Not everything that’s bad for us is banned.The medical information is important. It needs to be taken into account that cannabis is bad for mental health, end of story. But there is a bunch of other considerations, to be taken on board, such as, for example, what are the pluses and minuses of our current policy regarding cannabis. What are the costs of our current policy in terms of criminalisation, and so forth. What would be the costs of legalisation.”

He suggested that the correct response to individual cannabis use should be far more of a medical response, a social response, a supportive response.

“So there should be a degree of decriminalisation, however, legalisation would be a step too far.”

Legislation

Prof Kelly also said that implementation of the new public health alcohol legislation could not come quickly enough, particularly in relation to the minimum unit price.

"You know in Ireland 22 per cent of the population drink two thirds of the alcohol. We're second out of 194 countries for binge drinking. So when you look at problems that really affect the population. This is one of them . . . alcohol . . . and why?"

“Bottled water is more expensive than alcohol when you’re out so when people are going to drink . . . they’re going to drink more of it . . .”

He said the introduction of minimum unit pricing for alcohol in Scotland had had a dramatic effect that was quite extraordinary.

“Prices went up, and there was a reduction in shop purchases of alcohol . . . minimum unit pricing doesn’t affect the price of alcohol in bars or places like that, which is already, way above the minimum price. It affects the people who are buying large crates of cans in supermarkets. These are the 22 per cent who exert a huge cost on health service.”

"Since it was introduced, alcohol related deaths in Glasgow have fallen by 20 per cent. So minimum unit pricing literally saves lives."

In his address on rhetoric and reality in mental health, Prof Kelly also said that improvements were being made to services in Ireland but more needed to happen and more quickly.

Psychiatric hospitals

He said a few decades ago Ireland put more people into psychiatric hospitals per head of population than anywhere else in the world. There were 20,000 people in psychiatric hospitals in 1963 but in the intervening period there had been a major transformation.

"We went from a situation where we had more than anywhere in the world. Now we're the third lowest in Europe for inpatient psychiatric beds . . . an extraordinary turn-about in four or five decades.

“Again, if you look at EUgraph, we have the third lowest psychiatric admission rate in Europe. So not a very in-patient oriented service. Indeed the complaint one hears nowadays is not about inappropriate psychiatric care or over enthusiastic hospital admission . . . you hear difficulties accessing care and this is the issue at the moment .”

He said there had been a pretty steady downward trend in suicide in Ireland. But the problem was that this was not evenly distributed.

“We have very specific problems, the rate of suicide and the travelling community is between six and eight times that of the general population. And our rate of suicide among children is the ninth highest of EU. So there are two problem areas that need work, but overall the trend is downward.”