Mental health services ‘deplorable’

TREATMENT for mentally-ill patients is “in a deplorable state” because of inadequate funding, the Irish College of Psychiatrists (ICP) said yesterday.

The organisation yesterday expressed serious concern about the lack of responsibility for psychiatric services at departmental level and the failure of the authors of the Hanly Report to seek the opinion of psychiatrists about reform.

Addressing the Joint Oireachtas Committee on Health yesterday, ICP chairperson Dr Kate Ganter complained that funding of mental health services had fallen from 11% of the total health budget in 1997 to 6.6% last year.

Dr Ganter questioned why there was such serious under-resourcing of psychiatric care when all reports from the Mental Health Inspector had highlighted major deficits in the service. Many psychiatrists were “bogged down and burnt-out” from dealing with such a lack of resources, said Dr Ganter.

The ICP reminded the committee that mental health problems will affect 25% of the population at some stage in their lives. Ten per cent of people with a severe mental illness die by suicide. Problems identified by the ICP are:

Major discrepancies in funding of services between health boards.

83% of consultants have no access to a psychotherapist.

45% of acute psychiatric beds in the Eastern Regional Health Authority area are blocked.

180 out of 400 clinical psychology posts are vacant.

Lack of places for postgraduate training of clinical psychologists.

The absence of specialist mental health services for older people.

Members of the committee variously described the picture painted of mental health services as “absolutely damning” “pretty atrocious” and “shocking.”

Senator Mary Henry (ind) said politicians had to take responsibility for the appalling condition because they had brought in mental health legislation without providing adequate funding to implement it. However, she cautioned the ICP against being optimistic of major improvements because of the hidden, low profile nature of such services. “There are no votes in mental health,” said Dr Henry.

Dr Ganter recommended that priority should be given to focusing on the establishment of multi-disciplinary teams as recommended in the Hanly Report. She noted that variations in the size of such teams directly affected admission rates to psychiatric hospitals and the use of non-drug treatments.

Dr Ganter said that psychiatric patients could not be treated overseas under the National Treatment Purchase Fund or other initiatives, even though there were waiting lists of more than a year for such services in some areas.

The committee heard that psychiatric services for children and adolescent were even worse than for adults, with just 20 beds for children under 16, despite recommended levels of 144 beds.

Dr Brendan Cassidy, a psychiatrist at the Cluain Mhuire Day Hospital in Dublin, said it was indicative of the general concern about mental health services that they were the subject of a report on Ireland by Amnesty International.

He also criticised the authors of the Hanly Report for failing to seek observations from the ICP.

Under Hanly’s plans for the Dublin area, 160 beds for psychiatric patients would be opened at St Vincent’s Hospital. “They are d marginalising and stigmatising people again,” he said.

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