Mental health system in need of vital treatment
Unemployment and income inequality are persisting and a rise in the rates of suicide and self-harm has been reported in recent years.
The link between recession and poor mental health has already been firmly established, as reported by the Mental Health Commission in 2010.
Now more than ever, the Government has a duty to protect the vulnerable in society. In the Programme for Government, a commitment was made to “vastly improve access to modern mental health services in the community”, in line with the recommendations of the mental health policy A Vision for Change. In Budget 2012 the Government made two important commitments in this area. The first was to expand the National Counselling Service to include all people on medical cards. The second was to develop community mental health teams for people with mental health conditions. Both have been delayed. These delays must be seen in the context that 600 mental health beds have been cut since 2006, on the understanding that community services would be developed — €35m was to have been invested in these vital community mental health services this year. There is an urgent need to fulfil the promised investment.
Ireland’s mental health services are in a time of transformation and transition, from the old, institutional model of hospital-based care to a new model of community-based services. Notwithstanding the country’s economic difficulties, it is crucial that the Government’s commitment to reforming mental health does not waver. Important structural and cultural change is under way and any further cuts to the mental health budget bring the possibility of undermining work already done and risking safety within our existing services.
Mental health services once again took a disproportionate hit in staff numbers early in 2012 as a result of early retirements. According to the Psychiatric Nurses Association, 425 mental health nurses retired in January and February. The combination of these retirements and the continuing recruitment moratorium is putting services under critical pressure.
In the HSE region of Dublin Mid-Leinster, we saw posts intended for community-based services being diverted into in-patient services because of staff shortages. This is counter-productive. It takes staff from less costly community mental health teams that support people to stay out of hospital and transfers the resources to more costly in-patient units. A HSE study of Kildare mental health services published this year found that a community-based service costs one fifth less per capita than the traditional hospital-based model. In the context of austerity, surely the Government cannot ignore the cost-effectiveness of investing in community mental health services?
Mental Health Reform has launched a nationwide campaign to urge the Government not to drop the ball on mental health, but rather to continue to invest in reform of services and support. We are calling for the Government to:
* continue to invest in comprehensive, holistic community- based mental health services, including an additional allocation of €35m in 2013 for community mental health services as promised in the Programme for Government;
* invest in the governance structures to support A Vision for Change, including resourcing support for the director for mental health;
* ensure no further cuts to funding for mental health and related voluntary and community groups;
* fund innovative peer-led local groups.
As we travel around the country with our campaign, a striking number of people have told us of the mental health difficulties they or a loved one have experienced. This seems to indicate an increasing openness to talking about the issue, but also highlights the widespread need for support, including access to counselling and psychotherapy. As public support for the campaign grows, we hope that our collective voices will be heard before the Government makes any budget decisions that might cause long-term damage. Now is not the time for short-term thinking on mental health.
* Orla Barry is director of Mental Health Reform. For more on the campaign see mentalhealthreform.ie
Mental Health Reform have published a collection of audio shorts, titled “…Because It’s Time”. They bring together different voices, across generations and regions, to tell a story about mental health in Ireland – what’s working, what needs to change, and why the issue should matter to us all. Production was designed, edited and produced for Mental Health Reform by Victoria Enright, VE Productions.
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