Lack of rehab means 1,000 people in supervised residential centres cannot move to more independent living

A Vision for Change – a strategy document published in 2006 that set out the direction of mental health services in Ireland - recommended the establishment of 48 rehabilitation teams based on the current population.

Mr Farrelly said there were currently only 23 “very poorly staffed” teams.

“Our only specialist rehabilitation in-patient units are private, with the HSE funding beds and providing an out-of-area service, a practice which has been strongly criticised internationally,” he said.

We have over 1,000 people in highly supervised residences with little or no prospect of moving to more independent living due to a lack of both adequately resourced rehabilitation teams and suitable accommodation.

Earlier, Mr Farrelly said it was evident that the provision of mental health services was “inconsistent” across the country because of a lack of proper planning, resourcing and integration.

He said the decision by the HSE to remove the post of national director for mental health sent out a “clear and unambiguous, although perhaps unintended” message that mental health was not a priority.

“It is also evident that this has negatively impacted on the delivery of services nationally,” he said.

“The fact that this was permitted to occur in addition to the slow, ad hoc, and unmonitored implementation of A Vision for Change is disappointing.”

While the commission can inspect all mental health services, under existing legislation, it is limited to in-patient facilities only.

“We welcome the work of minister for Mental Health and Older Persons, Jim Daly, to drive change in this area by commencing a process to amend the current Mental Health Act,” said Mr Farrelly.

Replying to Sinn Féin's Louise O'Reilly, Mr Farrelly said it was very hard to get “clarity and accountability” in the mental health services.

Mr Farrelly said Ireland seemed to be “consumed” with in-patient beds instead of developing community services where people wanted to be treated.

A lot of services like Jigsaw, the national centre for youth mental health and Pieta House which provides support for those in suicidal distress or engaging in self-harm, were “born out of gaps” because the services were not there.

The inspector of mental health services, Dr Susan Finnerty, said the HSE's Child and Adolescent Mental Health Service only had one emergency bed and that was in Galway.

“The lack of emergency beds is quite stark in the CAMHS service,” she said.

Mr Farrelly said primary care facilities were being developed around the country and those facilities could be open around the clock.