Mental Health Commission report highlights impending crisis

“Entirely unacceptable and inhumane.” That one, let alone “a number” of mental health facilities are being described in such a manner is a chilling indictment of Ireland’s mental health service.

In addition, the Mental Health Commission’s (MHC) annual report, released today (16/06/10), also states there has been no overall discernible improvement in services in 2009, despite pockets of progress across the country.

Orla Barry, Director of the Irish Mental Health Coalition, said: “It is deeply worrying that the MHC’s report describes 2009 as a year in which there was only ‘limited change of a positive nature on the ground’ and that there were ‘no major improvements in the quality of care and treatment’.

“Cuts in staffing, buildings that are unfit for purpose, a slash to funding, a lack of compliance with basic standards and no meaningful plans to drive reform are a potentially toxic combination that will lead to crisis unless there is immediate action.

“The report points out that staffing cuts are hitting progressive community teams - where they do exist - ‘causing a reversion to a more custodial form of mental health service’. In inpatient services we are also particularly concerned that ‘slippage’ was noted in a number of areas including staffing, therapeutic services and programmes, recreational activities, privacy and premises. Inevitably these deficiencies are having an adverse effect on the quality of service being received by people.

“We have reached crisis point. The HSE clearly is not delivering on its promises. The Government must now ensure that targets for reform are met; that new facilities are opened this year, so that the out-dated psychiatric hospitals can be closed, and that the money follows policy into creating a modern, recovery-oriented comprehensive community based mental health service.

“We welcome the MHC’s call to cease new admissions to St Brendan’s, Dublin, St Ita’s, Portrane, Co Dublin, and St Senan’s, Wexford, but where are the HSE’s plans for those people who remain in these and other inappropriate services?

“In March the Minister for Mental Health and Disability John Moloney, pledged to close 15 Victorian hospitals still in use – but there are still no published, time-lined and budgeted plans to effect this and to develop the necessary alternatives to take their place.

“Year after year the Inspector for Mental Health Services and the Mental Health Commission outline critical failures and yet year after year we see little improvement. The impact on the lives of people experiencing mental health problems is profound. Unless there is action, people will become and remain unwell for longer. This will have significant personal, social and economic costs.”

Colm O’Gorman, Executive Director of Amnesty International Ireland, said: “The continued failure to improve mental health services is having a detrimental impact on people. It is also a stain on Ireland’s human rights record.

“While we acknowledge the significant decrease in the numbers of children and young people admitted to adult units during 2009 (from 247 in 2008, to 200 in 2009), any such admission is unacceptable.

“If any other health system did not have a focus on recovery at its heart, we would be rightly outraged. The MHC report is clear: those services that do promote recovery ‘have lower remission rates [and] less relapses’.

“The missing piece in the puzzle is law to drive the delivery of comprehensive and fully resourced community mental health services, and ensure greater transparency and accountability.

“The Government’s 2006 mental health policy, A Vision for Change, reiterated past promises and underlined the need for a shift away from over-reliance on hospital-based care towards a greater focus on community-based services. But to date, policy alone has not been able to drive this change. After 25 years of broken promises, we believe legislation is needed if this shift is to be realised.”

Mr O’Gorman added: “We welcome the Minister’s commitment to capital development earlier this year, but the HSE’s first financial report for 2010 highlights that capital spending that is supposed to enable closure of the out-dated hospitals is behind schedule.

Ms Barry added: “While the absence of investment is clearly having an impact, it is clear that the problems highlighted cannot be explained or excused by the economic situation. There is an absence of basic and effective management systems and accountability. Clear, decisive action must be taken urgently to address the intolerable situation highlighted by the report. The MHC report recommends that the Assistant National Director for Mental Health Services should be elevated to the status of Directorate and be given executive and budgetary powers. This must now happen.”