Health and care services

What’s another year?

*** NO REPRODUCTION FEE *** DUBLIN : 24/01/2013 : On the 7th anniversary of A Vision for Change, Mental Health Reform coalition urges action. Seven years to the day after the publication of the mental health policy A Vision for Change (AVFC), Mental Health Reform calls on the Government to prioritise its implementation. Orla Barry, Director of Mental Health Reform, commented: “It is striking that, despite the Government’s stated commitment to developing community mental health services, the years since the publication of A Vision for Change in 2006 have seen the proportion of spending on mental health services decrease from 7.2% to 5.3% of the overall health budget. According to the HSE’s Health Service Personnel Census for December 2012, mental health staffing levels dropped by 12.1% between 2009 and 2012. This overall reduction in staffing levels further hampers efforts to achieve A Vision for Change and denies people the range of supports they need.” Pictured (l-r) on the holding seven clocks representing the 7th anniversary of A Vision for Change were Mental Health Reform volunteers Hannah Ryan, Stephen Garry, Donal Browne, Aisling Concannon (centre), Kate Purcell, Andy Haughey and Christine Hynes. Picture Conor McCabe Photography.

Media Contact : Lara Kelly, Communications and Campaigns Officer. Phone (01) 6121422 Mobile (087) 6189715 Email : lkelly@mentalhealthreform.ie As Mental Health Reform prepares to mark the eighth anniversary of the Government’s mental health policy, Shari McDaid looks at where Ireland is lagging behind.

What did we learn about mental health in Ireland in the last year? We heard worrying news that children and young people in Ireland have a higher rate of mental disorder than elsewhere in Europe or the USA, based on research conducted by the Royal College of Surgeons in Ireland.

We learned that there are still huge gaps in the support available to young people. As of September 2013, 400 children had been waiting more than a year for an appointment with a HSE mental health professional.

Children are still being inappropriately admitted to adult wards – 36 children and adolescents in 2013 – a situation which could increase the young person’s distress.

Many people in Ireland will experience mental health difficulties at some point in their lives. Even at the height of the economic boom, one in seven adults in Ireland reported having experienced a mental health problem in the previous year.

Ireland’s continuing economic situation is putting strain on the population. In the first nine months of 2013, more than 30,000 adults had been referred to community mental health services, according to the HSE.

But what kind of services will be available for these 30,000 people? ‘A Vision for Change’, the mental health policy published in 2006, is a ten-year policy that aimed to define the future of Ireland’s mental health services. It sets out a vision of modern, multi-disciplinary, community-based services, accessible to all.

As a coalition of 39 members, Mental Health Reform frequently hears the concerns of organisations and individuals about mental health services. The message is clear: people want to be listened to by their mental health service; they want a consistent relationship with a mental health professional; and they want an offer of treatment that goes beyond medication only.

Under Minister for Mental Health Kathleen Lynch, the last two years have seen commitments to the appointment of almost 900 new multi-disciplinary staff to community mental health teams. This would see occupational therapists, social workers and psychologists joining doctors and nurses in teams across the country.

However, many teams are still not fully staffed. While 95 per cent of the 414 staff promised for 2012 have completed or are in the final stage of the recruitment process, only 28 per cent of those promised for 2013 had done so by early December. Worryingly, the HSE’s National Service Plan for 2014 has stated that new staff for 2013 and 2014 will be “specifically targeted towards the latter half of 2014 to allow … savings to be utilised on specific services on a timing delayed basis.” This would be the second time that recruitment has been delayed specifically to find savings for the HSE.

There has been a disproportionate loss of staff from the mental health services during the economic crisis, with a loss of approximately one thousand out of ten thousand staff between 2009 and 2012. At the end of July 2013, 9,100 staff were in place. This is still 900 less than in 2009 and well under the number required under ‘A Vision for Change’.

If new staff are not hired to replace those leaving, people in severe distress may not have access to holistic support to aid their recovery. They will likely have to wait longer for psychological therapy or may not have access to occupational therapy or social work support.

Alongside investment is the need for a new culture within mental health services that fosters recovery and works in partnership with users of services and their relatives. This recovery principle should underpin all mental health service delivery in keeping with ‘A Vision for Change’. Some areas around the country are being innovative in adopting the recovery ethos and in 2014 the recovery-oriented service needs to become the norm.

Shari McDaid is Director of Mental Health Reform.

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