Mental health system reform at critical junction

Mental health services are on the brink of major reform, but there are significant barriers blocking progress, Amnesty International Ireland will say today 13-05-10.

They must be removed if the Government’s four-year-old mental health policy A Vision for Change is to be implemented. While these barriers continue to be in place, they are seriously affecting people’s lives.

A new report outlining how effective monitoring mechanisms would drive progress in mental health reform, Accountability in the delivery of A Vision for Change, commissioned by Amnesty International Ireland and written by Indecon International Economic Consultants, will be launched today in partnership with the Irish Mental Health Coalition. It contains solutions to the ongoing problem of lack of effective reform of the mental health services.

Colm O’Gorman, Executive Director of Amnesty International Ireland, said: “Inefficient use of resources, slow pace of reform, crisis in staffing have brought us to a critical place. There is a human cost and impact in all of this. People’s lives - their ability to recover, to live a full life in the community, to work, maintain family contacts - are at stake here. We must act now.

“Irish people deserve a mental health service that not only meets our international human rights requirements but actually improves the lives of those who use it. But in order for this to happen there has to be accountability for the reform, delivery and transformation of our mental health services. Mental health must be made a political priority and the Government must show its commitment to reform.

“The Government’s mental health policy, A Vision for Change, promised transformation - a shift away from hospital care towards a system that provided a range of mental health treatments, available within the community. Yet implementation of this four-year-old policy is painfully slow. There continues to be an over-reliance on crisis care and long stays in hospital instead of a properly resourced community-based mental health service.

“Indecon has produced a report that clearly and simply sets out how implementation of the mental health services as set out in A Vision for Change can be effectively monitored. If the Government and the HSE adopted the recommendations outlined in Accountability in the delivery of A Vision for Change, we are confident that the transformation of Ireland’s mental health service would be achieved.

“As the report recommends, we need to set goals that effectively monitor financial accountability, performance in terms of staffing and facilities, the quality of services and the outcome for those accessing services. If we do that then we are more likely to get the long-promised transformation in mental health service provision."

“Among its recommendations this report urges the Government to consider using the law to drive the delivery of fully staffed community mental health teams. We believe this is the missing ingredient and would be a huge step towards driving implementation.”

Mr O’Gorman added: “The risks are clear - without an inter-departmental approach and the delivery of adequate community-based services there is a real risk that future service users will be essentially re-institutionalised in the community.”

Caroline McGrath, Director of the Irish Mental Health Coalition, said: “It is totally unacceptable that four years after A Vision for Change was published, the proportion of health budget spending on mental health is decreasing. The 2010 HSE Service Plan allocates only 5.4 per cent of the total health spend to mental health. This is a reduction on 2009 and falls far short of the 8.24 per cent recommended in A Vision for Change.

“The failure to protect the already poor position of mental health cannot be tolerated and means that the most basic of services are not available to people in urgent need. The situation cannot be explained or excused by the economic situation. It is the result of the absence of basic and effective management systems and accountability.

“Clear decisive action must be taken to implement effective systems and clear accountability to drive and promote reform. A starting point must be ensuring budget control for mental health moves to the Director of Mental Health Services. Only then can we hope to achieve the transformation to community-based, accessible mental health services which support recovery and well being."

“Capital development and improvements on current residential facilities are very welcome; however beds alone cannot help people to recover and live a full life in the community. Skilled staff, social workers, psychologies, occupational therapists, nurses, working to provide specialist services is the community are the backbone of mental health services.”

Read our Report attached below