Real change needed in mental health care

FIRST, congratulations to the Irish Examiner’s Jennifer Hough for the excellent special investigation into the topsy-turvy world of mental health treatment in Ireland.

It is clear from your investigation and from previous experience that there is an almost total reliance on drug treatments for psychological difficulties. The evidence has been mounting that much drug treatment is not just ineffective, but can be positively harmful, as Dr Dermot Walsh indicated.

It is criminal to continue to spend hundreds of millions on ineffective or harmful approaches rather than on effective forms of healing which actually work. These funds should instead be devoted to therapies and approaches which lead to true healing and recovery, along the lines of many “recovery” models developed in other countries, which have been shown to work and which are humane.

Part of the difficulty is the unwillingness of the Irish psychiatric establishment even to recognise the problem, its persistence in upholding a model which simply does not work, and its denial of two decades of evidence against its chosen model. Another part is the dominance of the drug companies, their symbiotic relationship with academic psychiatry, and their far too cosy relationship with the Irish Medicines Board (IMB), which they fund to the tune of 75% or more of its budget.

In 2007, the Oireachtas Committee on Health and Children made several recommendations which dealt with these concerns. It recommended that the IMB be broken up into two bodies, a licensing agency — to be funded directly by government and not the industry seeking licences — and an independent agency to handle pharmacovigilance, monitoring the safety of medicines and devices after they come on the market. It also recommended a big increase in the number of psychologists and counsellors available in the community health services so as to provide an alternative to drug therapy.

Neither of these has been implemented. Kathleen Lynch, Minister of state for mental health should immediately take a first step towards a recovery-oriented mental health service by taking these two vital steps, and follow that with rapid movement towards the necessary changes in the Mental Health Acts, as mentioned by Dr Pat Bracken, so as to enable a humane and recovery-centred approach to helping those afflicted with serious psychosocial distress.

Time is of the essence. A vision for change is, in many respects, a fine document. The problem is, it is only a vision. Since its publication five years ago little has changed, and many people, such as John Hunt, have been failed by and damaged by the system we have.

Ms Lynch is the third minister for mental health to hold the office — let’s hope she will be the first to introduce the kind of qualitative change that is needed, rather than merely the quantitative changes she catalogued in her own comment last Saturday, and will do so forthwith.

Basil Miller

The Wellbeing Foundation

Greystones

Co Wicklow