Patients in ‘revolving door’ system, Mental Health Commission warns

As with previous reports, the latest edition benchmarks progress, or the lack thereof, within mental health services against recommendations in the 2006 A Vision for Change document, launched by the government of the day.

Patients in ‘revolving door’ system, Mental Health Commission warns

The Mental Health Commission has slammed the “minimum improvement” in mental health services over the past 10 years and said many patients are in a “revolving door” system as a result.

The commission has today published its Rehabilitation and Recovery in Irish Mental Health Services report, written by Inspector of Mental Health Services, Dr Susan Finnerty, as well as 14 individual reports outlining the scale of the shortcomings in different regions around the country.

The commission focused on the “short-sightedness” of the long-term neglect of people with serious and enduring mental illness, led by a “wholly inadequate rehabilitation and recovery service”. Dr Finnerty said she had spoken with people in the system who were “frustrated and angry” that it was not meeting their its needs.

As with previous reports, the latest edition benchmarks progress, or the lack thereof, within mental health services against recommendations in the 2006 A Vision for Change document, launched by the government of the day.

The report said: “There has been minimum improvement in the number of rehabilitation teams between 2008 and 2018/19.”

It said there are 23 rehabilitation teams around the country — 48% of what is required. It also highlighted that rehabilitation teams are operating with just 35% of the staffing as recommended in A Vision for Change.

The report suggests those targets may now be out of date: “It is important to note that A Vision for Change was written 13 years ago and does not reflect the development of rehabilitation services internationally and in line with best practice.”

According to the report: “The lack of investment in rehabilitation mental health services has resulted in approximately 10% of people with enduring mental illness remaining in acute mental health inpatient units, often for months or years after the acute phase of their illness has been treated.

The difficulties experienced by these people are compounded by institutionalised care with its consequences of erosion of self-care and social skills.

Dr Finnerty also highlighted issues with insufficient training, out-of-area placement, the “real problem” of discrimination of people with mental health difficulties, and problems with discharge planning.

The report said there are 113, 24-hour supervised residences with 1,200 people who have severe enduring mental illness in them.

“At present, there is a serious lack of adequate housing and accommodation options for enabling service users to move through the different stages of recovery and progress towards the goal of independent community-based living.”

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