As Mental Health Reform launches an eight week campaign calling for investment in community mental health services, Director Orla Barry takes stock of why this funding is needed, and shares what Mental Health Reform has heard this year from people using the mental health services about their experiences of dealing with the system.
“When he’s suicidal, come back to us”. This is what a mental health advocate who attended one of Mental Health Reform’s public meetings was told by an overstretched mental health service when seeking support for someone experiencing a mental health difficulty. That service, it seems, was unable to provide support to the person until they were in crisis.
Another person told us about the lack of psychological support available to them: “I lost a psychologist. I was on a list to see her and then was told that she went on maternity leave and would not be replaced.” The Government’s mental health policy, A Vision for Change, calls for the establishment of multidisciplinary community mental health teams, composed of psychologists, social workers and occupational therapists, alongside doctors and nurses. A Vision for Change estimated in 2006 that 1,000 additional staff would be needed to implement the policy and yet, in 2013, the HSE is seeking an overall reduction of 2,400 Whole Time Equivalents.
A key part of A Vision for Change is that the principle of Recovery should be embedded in mental health services. This requires a cultural shift by services and means that services should focus on helping a person recover their well-being, and that each person should be seen as a partner in their own care and recovery. While some services have embraced the Recovery ethos, unfortunately this is not the experience of everyone using the mental health services, as raised by another of our meeting attendees: “How am I ever going to have choice if they keep deciding my treatment?”
An issue that Mental Health Reform has raised again and again is the patchiness in terms of the quality of mental health services around Ireland. So, while the people quoted above describe negative experiences, we also hear about community mental health teams providing excellent services:
“I get to see the same person all the time. We build a rapport.”
“I found they [staff] brought me back to life…I owe them me being here today.”
“Our community mental health nurse has set up a family support group. It’s been absolutely invaluable.”
These remarks show that there are pockets of excellence and many services that are doing their best, within limited resources, to deliver the type of recovery-orientated service set out in A Vision for Change. But properly developing our community mental health teams requires investment. We welcomed the Programme for Government commitment to invest €35 million specifically for the development of community mental health services in 2012, 2013 and 2014.
However, the follow through on this promise has been frustratingly slow. Of the 414 staff promised for community mental health services for 2012, we know that 383 staff are in place at the time of writing. Yet the net increase in mental health service staff from January-April 2013 was much less, at a total of 188.5 full-time posts. For 2013, a further 477 staff were promised but Mental Health Reform has serious concerns that the delays we saw last year in terms of appointing staff to community mental health teams are happening again this year.
In a campaign called Do What Works, we are calling on the Government to honour their commitment to invest in community mental health services. We know what works for mental health. What works are mental health services based in the community, with a range of multidisciplinary staff offering a choice of treatment options; easy access to mental health support from one’s GP; access to talking therapies; helping people with a mental health difficulty to get into and maintain employment and secure accommodation. These are effective and cost-effective recommendations which Mental Health Reform has made to the Government ahead of Budget Day on 15th October.
The Inspector of Mental Health Services noted in the 2012 Annual Report of the Mental Health Commission that mental health services were ‘stagnant and perhaps have slipped backwards in 2012.’ To keep moving the reform of mental health services forward, we are urging the Government to spend the €35 million allocated for community mental health services in 2013 and to avoid the delays in spending and staff appointments seen in 2012. For Budget 2014, we are asking that an additional €35 million – as promised in the Programme for Government – be allocated to community mental health services.
One in seven adults in Ireland will have experienced a mental health problem in the last year. That’s 644,000 people – members of families, workplaces, communities. As the debate about Budget 2014 heats up, we are asking the Government to do what works to improve everyone’s mental health in Ireland, and we invite the public to support the campaign by signing the Do What Works petition. Let’s not allow mental health to slip off the agenda this Budget Day.
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