The Government will sell off hundreds of acres of land from the country's biggest psychiatric hospitals to provide a major funding boost for the mental health sector, writes Carl O'Brien.
Health boards have identified more than 200 acres of land from 14 mental hospitals which officials expect will raise several hundred million euro.
The move is also expected to involve the closure of some old psychiatric institutions, which have been repeatedly criticised as "archaic", "unacceptable" and "unsatisfactory" by the Inspector of Mental Hospitals.
The Cabinet is understood to have recently agreed to ringfence all money raised by the sale of land for the mental health sector, despite opposition from the Department of Finance. The money will be used to establish community-based facilities, staffed by multidisciplinary teams of health professionals, according to Government sources.
The Minister of State for Health, Mr Tim O'Malley, has confirmed that a project team has been set up to prepare for the sale of the lands.
"I have been appalled to see the conditions in some mental health institutions, while at the same time there might be 10 or 15 acres of very lucrative land surrounding the hospital not being utilised. This doesn't make any sense. I passionately believe we should convert land assets into health assets," he said.
The land available for sale includes 30 acres at Newcastle Hospital, Greystones, Co Wicklow, 20 acres at St Joseph's Psychiatric Hospital, Limerick, and a large land bank at St Ita's, Portrane, Co Dublin. The first land to be sold will be the 34-acre Central Mental Hospital site, which is expected to raise €70 million.
However, money raised by the sale of State land will still be relatively modest compared to the €680 million annual budget for the mental health service.
The funding is expected to help kick-start the building of more appropriate community-based facilities, two decades after a Government blueprint, Planning for the Future, recommended such measures.
Some institutions are expected to close and relocate to community settings, while others may remain in their existing location but on a smaller scale. These decisions will be taken on a case-by-case basis, according to Government sources.
The need for such large institutions is questionable, given that the number of in-patient beds in mental hospitals has declined from 12,900 in 1984 to around 3,800 in 2002.
The new State watchdog for the mental health sector, the Mental Health Commission, last week said funding needed to be doubled immediately to help bring services up to acceptable standards.
Figures show funding for the sector as a proportion of the overall health budget has fallen from 11 per cent to 6.8 per cent since the 1990s, a trend which has continued under the present Government.
The ringfencing of funds from the sale of land was agreed in response to concern that resources aimed for the mental health sector have frequently been diverted into other areas of health.
Mr O'Malley said there was enormous goodwill towards plans to sell off land and that he had already held discussions with representative groups, including the Psychiatric Nurses' Association and the Royal College of Psychiatrists.
The funding boost for the sector will also help implement a new mental health strategy, due to be finalised next year, to guide the development of mental health services for the next decade.
It is expected to recommend a radical overhaul of the sector, including the development of specialist services for children, adolescents, homeless and people with intellectual disabilities.