THE UPHEAVAL IN the health service and the impact of austerity have both slowed the implementation of Ireland’s mental health policy.
That’s according to a new, first-of-its-kind report commissioned by Janssen which assesses the degree of commitment in 30 European countries (EU28 plus Switzerland and Norway) to integrate people with mental illness into their communities.
Germany came out top, followed by the United Kingdom and Denmark, when it came to integration and mental illnesses.
The report looks at factors such as the environment for those with mental illness, their access to medical help and services, their opportunities, jobs, and efforts to combat stigma.
The White Paper highlights five areas for countries to focus on to improve integration of people with mental health issues.
Mental Health in Ireland
Professor Brendan Kelly, Associate Clinical Professor of Psychiatry, University College Dublin and Mater Misericordiae University Hospital Dublin told TheJournal.ie that in Ireland we have a “very good mental health policy”, A Vision for Change. But he said it had a record of limited implementation.
He pointed out that Ireland’s mental health budget makes up 5.3% of its entire health budget, which is a decrease in the past number of years. “The absolute amount has also decreased as well, which is concerning,” he said.
Kelly said that in Ireland, unemployment is now at 11%, but among people with mental illness, the rate is approximately 80%. “There is a huge issue there in terms of the workplace,” he said. “What the report highlights is how to fix this.”
Prof Kelly said that countries that are the most successful with integrating those with mental health issues use a system called ‘place and train’ rather than train and place. that is, people are placed in a job and then supported while in the job.
He said that UK studies have shown that by placing people in jobs and supporting them, every £1 spent on that will save society £1.60.
Other steps could be taken with regard to the stigma around mental illness, he said.
People with mental illness should not be defined by mental illness.
Kelly said that the ideal would be moving way from a silo-based approach, where you have different elements of care in different areas, and instead linking these up. This, he said, is an issue of coordination rather than funding.
Key issues
In his clinical practice, people with mental illness and their families pinpoint the key issues for them as housing, daytime activities, training opportunities and social welfare benefits.
“A lot of people come up with difficulties that family and friends struggle to accept mental illness as being as serious as a broken leg,” he said, adding: “Usually family and friends can come around.”
He said that people with mental health issues can end up prison, but somebody without these issues who commits the same offending behaviour might not spend time in prison. There are also issues with homelessness and offending, and it is “extremely difficult” to treat mental illness in someone who is homeless.
People with mental health issues can also find it difficult to access care for physical illnesses, he said.
Suicide in Ireland
Professor Kelly said that this report “shows quite clearly that of people with mental illness, 75% have an onset before 25 years of age”.
We know the decade leading up to 25 years is a high risk period for suicide, particularly for Ireland. Ireland has the fourth highest suicide rate in that age group in the EU 28 which is very high.
This is compared to the fact that overall, as a country our suicide rate is the eighth lowest in the EU 28.
“We really need to ask ourselves as a society how are we failing young people to that extent.”
Speaking out
When asked about the benefits of people speaking out about their mental health, Prof Kelly said:
I continually meet people that say they benefited from hearing someone talk about it on the radio or newspaper or online publication.
He said that each time a well-known person speaks out, “there are a new group of people who see it for the first time and feel liberated and able to talk to others”.
“We would hope that this report would be read by those with the power to change things,” said Prof Kenny.
He said that if people reading this article are moved by it, the “correct course of action” is to use the democratic process: “Next time an election rolls around, bring it up on the doorstep.”
The full Index report and Ireland’s Country Profile are available to download at Janssen.ie.
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