The Mental Health Commission has highlighted common and “quite astounding” deficiencies across the country in mental health service provision, from Cork to Donegal.
The author of the main report, Dr Susan Finnerty, said: “The long-term neglect of people with severe and enduring mental illness has negative outcomes for the service user and their families.
"Because of the unmet need for rehabilitation, many people with enduring mental illness have repeated admissions to inpatient psychiatric units, are then discharged, to be readmitted when things breakdown again — the so-called ‘revolving door’ of admissions.
“In the long-term, this is counterproductive for both the service user and the already severely under-resourced acute services.
The short-sightedness of not providing adequate mental health rehabilitation services, from both a human rights and a financial viewpoint, is quite astounding.
Area-by-area, that picture emerges. The report for Donegal (CHO1) states that the rehabilitation service there is “completely inadequate and does not serve the needs of people with serious and enduring mental illness”.
Cork and Kerry Mental Health Services (CHO4) has 340 people with enduring mental illness living in institutionalised care — hospitals or 24-hour supervised residences — but has “only two poorly staffed rehabilitation teams”.
According to the report:
It is difficult to see an improvement in services for people with severe enduring mental illness without major investment in rehabilitation and recovery services.
Issues in Carlow/Kilkenny/South Tipperary Mental Health Services (CHO5) include ongoing staffing problems, insufficient social and low supported housing, with the lack of a Mental Health Intellectual Disability team leading to “inappropriate care for this resident group”.
In Dublin South East, East Wicklow Mental Health Services (CHO6) the absence of any rehabilitation team in Community Healthcare East is a “major challenge” among many others, while in Galway one challenge is “political and public opposition to closure of some residential units, which would allow residents to move to more independent living and recovery”. This “flies in the face of government policy ‘A Vision for Change’”.
The main report highlighted the fact that there are just two specialised inpatient rehabilitation units, one in Dublin and one in Cork, which had “the immediate result of out-of-area placement of people with enduring mental illness”, a practice criticised by the MHC.