Madam, – “Mental Health Services in free fall” (Home News, August 12th) highlights serious issues, as reported by the Psychiatric Nurses Association, about the management and resourcing of our mental health services.
The Irish Mental Health Coalition is gravely concerned that financial and staffing restraints are impacting negatively on the quality of services provided to service users and their carers, leaving individuals and communities without access to urgently needed, accessible community based mental health services. We have a modern national policy framework, A Vision for Change, which has not been implemented. At the heart of this framework is the creation of locally-based community mental health services which provide early and effective supports for people experiencing mental health difficulties. The quality of Ireland’s national mental health service has not been prioritised by Government and we are now at risk of losing the ground that has been gained.
The recent loss of 700 staff within mental health services and the continuing drain of experience, as key professionals retire, poses a critical and urgent issue for the HSE and Government to address. Already there is evidence of regression in our mental health services. As noted by the Inspector of Mental Health Services in his 2009 report when commenting on the reduction in mental health staffing: “Unfortunately and ironically, when cuts were made, it is the progressive community services which are culled, thus causing reversion to a more custodial form of mental health service”. This position is entirely unacceptable.
In an environment of cost cutting within the HSE, the Mental Health Services are already disadvantaged. Spending on mental health has dropped from 13 per cent of the health budget in 1986 to 6.4 per cent in 2009 and 5.4 per cent in 2010. A Vision for Change recommends that the rate reach 8.4 per cent which is a reasonable level relative to a percentage of 12 per cent in England and 18 per cent in Scotland. It is unacceptable that Mental Health Services continue to be an easy target for financial cuts. The reduction, in the percentage of health funding spent on mental health services between 2009 and 2010 illustrates starkly that mental health services are bearing a disproportionate level of health cuts.
A concession announced by the Minister some months ago allowing for the recruitment of 100 posts in mental health, is grossly inadequate when there is a critical drain of staff and increasing demand on services.
The people who need the support and skilled care of mental health services are individuals who are emotionally sensitive and vulnerable to mental distress. The provision of calm and stable environments and humane, consistent, expert, interpersonal support, focused on recovery, is inherent in providing quality mental health services. It is the responsibility of the HSE and Government to ensure this quality service is provided. The development of multidisciplinary Community Mental Health Teams delivering services at the lowest level of complexity with a reducing reliance on inpatient facilities, makes economic sense and is in keeping with international best practice.
Research consistently shows that one in four of us will experience a mental health difficulty at some time in our life. In addition the established links between mental health, poverty and unemployment means that demands on mental health related services grow in times of economic and social difficulty. Now, more than ever, quality mental health services are needed to respond to the urgent need of many people experiencing mental health difficulties in families and communities. – Yours, etc,