Mental health services funds warning

IT is impossible to implement the Government’s plan to reform mental health services without more staff and further investment, the HSE’s mental health boss has admitted.

Speaking ahead of a conference on the future of mental health services, assistant national director for mental health at the HSE Martin Rogan said “the cavalry” – 1,800 promised additional staff under a Vision for Change – had never materialised. Mr Rogan, who has worked in mental health for 30 years, said the most basic facet of mental health services was the interaction between skilled staff and the service user in his or her own community. “You can’t do that artificially or synthesise it – it’s just not possible without the staff,” he said.

Mr Rogan said the last 20 years had been spent building up the mental health budget, but as staff were retiring they were taking the budget with them.

In 1966 mental health accounted for 23% of the entire health budget, however by 1984 this had dropped to 12% (incidentally the percentage recommended by the WHO and Vision for Change). In 1990 it fell back to 6.8% and now the budget is at a new low of 5.3%.

“As staff retire, their salary comes out of the budget. We have lost so many staff in recent times that they are literally taking the budget with them,” he said.

Mr Rogan said it had taken a lot of work with officials in the Department of Health and Finance – and a meeting with the Taoiseach to get an exemption to recruit 100 staff.

And while he lauded the work Junior Minister John Maloney has done in the area, and investment in 16 projects around the country this year, Mr Rogan said it was difficult to see how mental health services will escape further cutbacks in the upcoming budget.

“Looking at the climate it is hard to be confident, but my obligation is to deliver Vision for Change when it is paid for. If it can’t be paid for it can’t advance.”

Mr Rogan said it was “very disappointing” that the Psychiatric Nurses Association (PNA) has resorted to using scare tactics reinforcing negative stereotypes of mental health patients in order to get a point across.

He was referring to a recent report by the PNA which highlighted the use of security staff for disturbed patients in psychiatric units.

“As health professionals we have access to people at hugely vulnerable times in their lives, and there is huge trust in that, so it is a betrayal when stories like this emerge. For whom was the PNA making a point?

“The service user movement is very unhappy about the way they have been portrayed and I believe have written to the PNA about it.

“They fully support the basic argument to protect the service – but not by vilifying people.”