Mental health services - We must find resources to end misery

OVER the last number of years there has been a new determination and urgency to try to improve the circumstances of those who depend on long-term state care because of mental health difficulties.

This was epitomised, in 2006, by the publication of A Vision for Change which promised radical change and improvement in the way we support people with mental illnesses. There was, and remains, a general recognition that far too many of the institutions used by people with mental health illnesses, and in some instances intellectual difficulties, are unfit for human habitation much less recuperation.

Some were so poor that the residents and staff endured circumstances that would not have been accepted in any other full-time residential setting.

Unfortunately that commitment to improve things has not been matched by the level of achievement everyone would wish for and, despite some progress and limited resources, far too many people continue to live in conditions that fall a long way short of what a humane society should automatically provide.

The minister with responsibility for mental health services, John Moloney, has acknowledged this. He has brought a new determination and humanity to the brief and has been honest about the system’s shortcomings. He has recognised that some of the facilities still in use, a number of which pre-date the establishment of the state, have no part to play in mental health care.

Unfortunately his good intentions, and the ambitions of everyone working in the sector, seem to have foundered along with our economy.

Nevertheless, over 800 people still live in psychiatric hospitals that are unfit for purpose, despite a series of Government promises to shut them down. Their situation must be improved even if that means cuts elsewhere; we simply cannot inflict this kind of hardship on our fellow citizens, and their families, while supporting so many unessential programmes in other areas.

The situation is acerbated by the recruitment embargo in mental health services and, though it has been relaxed slightly in the most urgent situations, it continues to have a considerable impact.

The Irish Mental Health Coalition (IMHC) has described the moratorium as a crude and brutal instrument that is crippling A Vision for Change.

Caroline McGrath, director of the IMHC, said: “The Government’s plan for moving from acute hospital care to a community-based service was based on redeploying staff and expanding the total number of staff. Instead, we have a service that is not even maintaining the status quo, but is haemorrhaging staff, reducing A Vision for Change to a mere pipe dream.”

This recession has forced us to reconsider many things; to reevaluate what we once imagined was essential, to prioritise in a way that shows what we really care about. It is unimaginable that there are not whole swathes of Government expenditure that are far less important than providing accommodation for the 800 sick people who endure conditions we would not inflict on animals. We cannot avoid our responsibilities in this area any longer.