DOCTORS HAVE expressed frustration that psychiatric patients are still being admitted to antiquated institutions despite long-standing plans to modernise mental health services.
In a new position paper on mental health, the Irish Medical Organisation says community mental health teams remain inadequately staffed for the provision of multidisciplinary care.
“With the current economic crisis and rising unemployment, the value of good mental health and good mental health services must be recognised,” the IMO paper says.
“Members of the IMO are now urgently calling for the Minister for Health to replace rhetoric with action and implement effective, sustainable mental health policy.”
Despite the increased pressure on services as a result of the economic downturn, spending on mental health has fallen from 12 per cent in 1990 to 5 per cent of the overall health budget this year.
It also says the failure to properly develop community mental health services – seen as the future for the sector – is having a major impact on the ground.
In a survey of GPs, the IMO found that issues most affecting the treatment of patients included access to public counselling and psychotherapists at primary care level.
Other issues include the cost of private psychotherapy services, communication with secondary mental health services and time constraints.
“The value of psychological therapies, including counselling, cognitive behavioural therapy, psychotherapy and group therapy, is widely recognised in the treatment of patients with mental health issues,” the IMO paper says.
“It is recommended in the mental health strategy that all individuals should have access to a comprehensive range of interventions in primary care for disorders that do not require specialist mental health services.”
However, primary care access to HSE psychological services is limited and the development of community mental health remains slow.
It says that less than half the number of target teams are in place and under a quarter of teams are at advanced functioning stage.
“A range of counselling and psychotherapy services are available in the private sector, however the cost of private therapy is prohibitive for many patients, particularly medical card holders and patients on low incomes,” the IMO paper says.
International best practice shows that the majority of emotional and psychological problems, such as anxiety disorders and mild to moderate depression, can be adequately treated in primary care.
More serious mental disorders such as schizophrenia, bipolar disorder, and severe depression and personality disorder require “balanced care” with a mixture of community-based and hospital-based services.
The IMO says investing in mental health services makes economic sense. Official estimates suggest the cost of mental health is in the region of €3 billion. Health and social care costs account for less than a quarter of overall costs.
The majority of costs occur outside the health system, in terms of lost output due to unemployment, absenteeism, lost productivity, premature retirement and premature mortality.
