The publication yesterday of a comprehensive report by the Irish Psychiatric Association into mental health services is most welcome.
By applying the latest techniques in the measurement of social deprivation, The Stark Facts offers a unique insight into the real state of psychiatric services in the Republic.
Its finding that the best facilities exist in areas of greatest affluence is a testament to the piecemeal way the present system has developed. Devoid of a national plan, it has been left to local interests to develop services as they see fit.
Unsurprisingly, those living in deprived areas have lost out; the authors of the report suggest that service users in more affluent areas would not tolerate the inadequate levels of staffing found in deprived areas.
Communities suffering the highest level of social deprivation have the lowest numbers of consultant psychiatrists relative to population. Numbers of occupational therapists and social workers are greatest in the most affluent areas of the state. The reality behind these findings is that those in lower socioeconomic groups end up overly dependent on a purely pharmacological approach to the treatment of mental illness.
People in deprived areas simply cannot access the many therapies offered to others in society. The fact that deprivation is associated with high levels of psychological ill-health makes such inequity even more disturbing; it effectively represents a double barrier which the less well off must overcome. A geographic inequity is also exposed by the psychiatrists' research. Specialist services - required to serve the needs of people with psychiatric conditions associated with head injury, childbirth and eating disorders - are generally not available outside the capital.
Clearly we need a national mental health strategy. It is to be welcomed that the Minister of State for Health, Mr Tim O'Malley, gave a commitment yesterday to commence this process in the near future. In the meantime, however, he should instruct all health boards to review service developments to ensure that resources follow psychiatric need. The reverse is no longer tolerable.