Support groups welcome the commission's plan for community care but doubt the Government's commitment. Alison Healy reports
A proposed move away from hospital-based to community-based mental health treatment has been welcomed by groups representing people with psychiatric illnesses and their families.
The proposal was made in the Mental Health Commission's strategic plan, which was launched yesterday. It said mental health services should be community-based, providing a range of "specialised multi-disciplinary community mental health teams".
However, support groups expressed concern that the Government would not deliver the necessary funding to provide these services.
Mr John Saunders, chief executive of Schizophrenia Ireland, said resources would have to be redirected within mental health services, and additional resources would have to be allocated to ensure that the appropriate services were delivered.
He highlighted the State's high rate of involuntary admissions to psychiatric units and said this was particularly worrying where schizophrenia and serious mental illnesses were concerned.
If the necessary back-up was provided to families in the first place, many of these involuntary admissions would never need to be made.
Yet the level of care provided by community and mental health nurses was "very, very inconsistent", Mr Saunders said.
"There are over 5,000 registered mental health nurses but a very small percentage of these are in the community," he said.
Dr Kate Ganter, chairwoman of the Irish College of Psychiatrists, said the proposed shift from hospital beds to community care was laudable but people working in child and adolescent psychiatry did not even have the most rudimentary access to hospital beds for acute cases. "We basically have no beds," she said.
In theory, 20 beds are designated for child or adolescent psychiatric patients in the State but, in reality, the figure is even lower, according to people working in the sector.
Dr John Owens, chairman of the Mental Health Commission, agreed there was an "urgent need" for investment in this area and said he could not understand why such a basic need had not already been met.
Meanwhile, the Carers' Association pointed out that funding in mental health services had decreased steadily in recent years but this had "largely gone unnoticed".
Its chief executive, Mr Enda Egan, called for a change in mindset from the Department of Finance.
"The care provided by families must be seen as an investment in the future. Up to now, the Department of Finance has been saying "we have been getting this care for nothing, so why should we start paying for it?", he said.
"They have to see that the investment in family carers is going to save money in the long run."
He pointed to the recent case where Ms Tessa Woods took the Southern Health Board to court for failing to provide adequate support to allow her to care for her disabled son at home.
The case was settled when the health board agreed to significantly increase its support services to Ms Woods.
"The health board was prepared to pay for care five days a week in a centre, yet they did not want to pay for care in the home, which is what they should be promoting," he said.
Mr Egan said people caring for mentally disabled relatives at home were at a disadvantage because they could not go on strike or hold the economy to ransom.
"If carers' work was reflected in the GNP or GDP of the country, then these problems would be solved long ago," he said.