Mental health reform 'slow and piecemeal'

More than 70 per cent of those admitted to psychiatric hospitals are readmissions suggesting that, for many people, admission…

More than 70 per cent of those admitted to psychiatric hospitals are readmissions suggesting that, for many people, admission to hospital brings no obvious lasting benefit, the Mental Health Commission has claimed.

In its annual report for 2003 published today, the Commission said Ireland still has high rate of admission to psychiatric hospitals compared to other countries.

The Commission also claimed the proposed move away from hospital-based to community-based mental health treatment has been "slow and piecemeal".

The comments will add weight to claims by mental health support groups that the Government is not providing the necessary funding for these services.

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The Commission, which was set up under the Medical Health Act 2001 to oversee the provision of mental health services, said Irish services remain influenced by an "institutional" approach to the delivery of care, claiming the use of beds and community structures "still dominate".

Despite the fall in bed numbers available at psychiatric units - from 12,900 in 1984 to 3,860 in 2002 - Ireland still has a comparatively high rate of admission and a high rate of psychiatric hospitalised death.

The Commission said: "Community alternatives for the treatment of acute illness in crisis have not been developed to any significant extent."

It said: "Secondary care mental health services still remain stigmatised and are often used reluctantly by those who could benefit from them.

"In this regard it is significant that GP referral rates are low by international standards," it concluded.

The Commission said the adult mental health care system remained predominantly a service that is "overly bed-based."

It said: "There are substantial problems in the overall management of the service, with no effective management structure to allow regional and national developments."

"Clinical governance structures are in their infancy and there is clearly a major deficiency not just in resourcing of services but in the appropriate use of available resources.

Speaking at the launch of the report, the Inspector of Mental Health Services, Dr Teresa Carey said: "Mental health services nationally must be community based to the maximum degree, be delivered by multidisciplinary teams and provide a range of specialist services to address areas of special needs".

The chairman of the Commission, Dr John Owens, said: "There is momentum for radical change and improvement in the nature and quality of mental health services."

Eoin Burke-Kennedy

Eoin Burke-Kennedy

Eoin Burke-Kennedy is Economics Correspondent of The Irish Times