Kildare psychiatric patients in funding black spot
The spending per head in Co Kildare in 2003 was just €37.97, compared to €495.47 in the St Brendan's Hospital area of Dublin.
In addition, areas of high poverty which have the highest rates of psychiatric disorders and the greatest need for services are the least likely to be well-resourced, according to a report by the Irish Psychiatric Association (IPA), published today.
The report, The Black Hole, which examined where funding on psychiatric services is going, found the biggest staff increase in mental health services between 1998 and 2003 was in administration up 56% compared to an 8% increase in nursing posts.
It found considerable variation in funding changes.
In Cork, in the North Lee area of the Health Service Executive (HSE), the budget was down €1.4 million in the five-year period, compared to an increase of €18.55m in Carlow/ Kilkenny.
"This was unrelated in any significant way to any increase in clinical services," the report stated.
It found no clear relationship between significant increases in budget allocation and the provision of new clinical services.
"The data suggests that 'new' funding attributed to improve mental health services may not actually have been spent on mental health and may have been diverted to other service areas," the report said.
Minister of State with special responsibility for Mental Health, Tim O'Malley PD, said the mismatch in funding was partly attributable to the fact that traditionally money had been spent in areas where there were big psychiatric institutions.
The number of psychiatric nurses per capita varies almost seven-fold, from one nurse per 246 catchment population (St. Brendan's Hospital, Dublin) to 1 per 1,802 catchment population (Kildare Service).
There was no relationship between population size served by a mental health service and the budget allocated.
Dr Siobhán Barry, one of the report's authors, said it showed a clear need for greater planning and accountability in resource allocation.
"We need to look at how resources are divvied up, at the moment they seem completely random and show no association with population size or social deprivation or anything that would normally determine service provision."
She said there was a dire need for service planning at a central level and that there had been none in the past 20 years.
Mr O'Malley said funding for the mental health service was now the responsibility of the HSE.
He said a working group he set up two years ago to examine the mental health service was due to report back before the end of the year.
