Government: what it knew and failed to do

THE following are reviews of key reports on mental health services in the past six years.

*The First Report of the Working Group on Child and Adolescent Psychiatry 2001:

This report said the country should have seven specialised in-patient units accommodating 140 children with psychiatric needs.

Special mention was given to the requirements of children suffering with attention deficit and hyperactivity disorders, and it highlighted the dearth of supports available.

However, it said absolute priority should be given to hiring the necessary staff to complete a network of comm unity care teams in every part of the country.

These teams were to include psychiatrists, psychologists, social workers, psychiatric nurses, language therapists, registrars and occupational therapists.

A price tag of €114 million was put on the plan and then Minister of State at the Department of Health and Children, Mary Hanafin said two teams had already been established in each health board area and in-patient units would be built under the 2000- 2006 national development plan.

What Happened Since:

One of the three in-patient units for children and adolescents has been shut. It specialised in young people who had come in contact with the justice system.

The closure was blamed on the lack of specialist staff.

Four more units were due to be developed but have not moved beyond the planning stage.

The community care teams, Ms Hanafin claimed were in place, are still not fully operational and many compromise of only two or three people.

In the following three years, an extra €6 million was spent in this sector.

*The Second Report of the Working Group on Child and Adolescent Psychiatric Services 2003:

The working group’s second report will be due for its five-year review before the majority of its recommendations are acted upon.

It said there were 2,816 people between 16 and 18 years of age in need of psychiatric treatment.

In 2001, more than 400 people in this age group were admitted to adult psychiatric wards, diagnosed with disorders such as schizophrenia, depression and other psychoses.

The review said these teenagers were falling between the cracks and should be able to rely on multi- disciplinary care teams, day hospital services, home support, in-patient beds and rehabilitation treatment programmes.

The review called for a consultant psychiatrist in each health board area, specialising in the needs of people in their late teens.

This specialist consultant would provide back-up to a local special care unit.

The report said once the special care units had been set up dedicated in-patient units should be established.

What Happened Since:

The specialist care units have not been forthcoming and in-patient services are still at the planning stage.

While teenagers are no longer in the adult category, they are now considered paediatric cases and there is even less cover than if they were treated as adults.

All of these recommendations are to be reviewed in 2008.

*A Vision Change: Report of the Expert Group on Mental Health Policy 2006:

This report said that the current level of service was well below the recommendations of previous reports and there was a major disparity between different parts of the country.

It said dedicated mental health services were virtually nonexistent and there was no capability to link up with hospitals.

This report again stressed the need for early intervention, and treatment within the school environment.

It said 13-member child and adolescent mental health teams should be provided at a rate of one team for every 100,000 people, with additional cover floating between areas.

These teams should in turn link in with hospitals, community care services and schools to adapt to specific needs in certain areas.

Urgent attention was called for to accelerate the construction of in-patient units at Cork, Limerick, Galway and Dublin.

What Happened Since:

A seven-member review panel was established by Minister for State Tim O’Malley in March, charged with ensuring the implementation of the document across a range of mental health services.