Time to spend more on mental health

FAR too many people, individuals and communities, have been forced to come to terms with the terribly sad reality that a loved, but distraught, relative has killed another, or others, in their family and then taken their own life. This all-too-regular tragedy is made even more difficult if children are, as they so often are, victims. There have been at least 27 such tragedies in Ireland since 2000.

Failed relationships, loneliness, financial stress or even homelessness are issues that can drive this lethal dysfunction but mental illness is a recurring, powerful and central player in these implosions. So, too, is the confidentiality around doctor-patient relationships. Because of this families are not always fully informed about the level of instability in a loved one’s life. Simply put families may not always know how very unwell a person is or be in a position to take proportionate measures to help that person or protect the wider family. A recent review of this principle concluded that it would be unwise to change current arrangements. However, families who have been sundered when a loved one breaks down and commits murder followed by suicide have challenged that view and it is very hard not to have great sympathy with their position. It is difficult, too, to exonerate a system that, in a different context, might be described as colluding in an arrangement that puts lives at risk by putting patient confidentiality before the safety of those living with that unfortunate and unwell person.

These are not the only issues challenging mental health services, a wing of our health system so very often treated in a way that suggests it is seen an afterthought. This perception remains despite commitments to introduce new systems and procedures to give patients the greatest chance of a full recovery and the prospect of resuming a normal life. Yesterday, in a prebudget submission, the College of Psychiatrists of Ireland expressed “dismay” over how very slowly the national mental health policy A Vision for Change is being delivered. This programme was to be a game-changer in the provision of mental health services and introduce a degree of humanity that was not always apparent in those services.