Lynch affirms commitment to mental health strategy

MULTIDISCIPLINARY CARE teams rolled out as part of the Government’s mental health strategy must become “embedded in the community”, Minister of State for Health Kathleen Lynch has told the Irish College of General Practitioners.

Ms Lynch, who holds responsibility for mental health services, has also acknowledged continuing “differences” within the medical profession over the approach.

Addressing the group’s agm in Galway at the weekend, Ms Lynch said she could understand how “difficult” change could be.

However, “from the point of view of people using the [existing mental health] services, we were doing very badly”, she told GPs.

Progress was being made, in that there were now 5,000 people in mental health institutions compared to over four times this figure (21,000) in recent memory, she said.

Ms Lynch, who elicited a warm reception from GPs at the agm’s forum on mental health, affirmed her commitment to implementing the strategy as articulated in the 2006 document on mental health, Vision for Change.

Ms Lynch said that she believed programmes which empowered children to become resilient and cope should be introduced in all school settings, as early as pre-school level.

Earlier, keynote speakers at the forum referred to the lack of support by psychiatrists for the “recovery” model of care, as defined in Vision for Change.

This model, with its emphasis on values and ethics, meanings and contexts, represented a “revolution” in understanding mental health, said Prof Patrick Bracken, consultant psychiatrist and west Cork mental health services clinical director.

The model did not mean “dumping drugs and therapy”, but the discourse was centred on a different approach, he said. Yet “many psychiatrists are not in tune with this”, he said.

Prof Bracken quoted from several studies dating to 2007 which showed that, while 70 per cent of people prescribed antidepressants said they “felt better”, some 10 per cent of patients failed to pick up their first prescription.

Up to 68 per cent of those who did pick up their medication had stopped taking it by the fourth week, according to the research. And 60 per cent of those who stopped taking medication had not told their doctor within three months, he noted.

Another study which examined psychotherapy found little evidence that specific cognitive interventions increased therapy’s effectiveness, he said.

“Patients get better, not due to specific technologies, but to the simple fact that we’ve intervened, listened and given advice – offering hope and a path to the future,” Prof Bracken said.

The mind was “not another organ of the body, like liver or kidneys”, he said.

Dr Bríd Hollywood, GP mental health lead for the Health Service Executive’s clinical care programme, paid tribute to Ms Lynch for “ring-fencing” €35 million for mental health.

Dr Hollywood outlined progress on setting up the multidisciplinary teams, and said that funding had been put aside for evaluation.

Part of the programme involved ensuring that GPs had the resources to keep young people out of secondary care for as long as possible, she said, and she also indicated that psychiatrists were resistant to the changes.