Call to realise mental health 'vision' now

A PLAN to reform mental health services drawn up four years ago should be implemented immediately, according to a report to be…

A PLAN to reform mental health services drawn up four years ago should be implemented immediately, according to a report to be published today.

The plan, A Vision for Change, was approved by the government in January 2006 and was to be implemented on a phased basis over 10 years.

It included proposals to sell mental hospitals across the State and use the funds generated to improve mental health services in the community.

The report being published today calls for the implementation plan for A Vision for Change to be published on the Health Service Executive’s website, along with a funding programme.

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The report, Accountability in the Delivery of ‘A Vision for Change’, by economic consultants Indecon, was commissioned by Amnesty International and the Irish Mental Health Coalition.

It examined the 2006 plan for transforming the mental health service, which remains largely unimplemented.

“There continues to be an over-reliance on crisis care and long stays in hospital instead of a properly resourced community-based mental health service,” said Colm O’Gorman, director of Amnesty.

The report says there is a need to ensure consistency between the figures presented on actual and planned mental health expenditures in the annual revised estimates published by the Department of Finance and the HSE.

The implications of any recruitment moratorium on the implementation of A Vision for Change should be shown in the HSE’s annual service plans, it states.

It also says the service plans need “improved transparency” in relation to the level of detail provided on actual and planned mental health expenditures.

The assistant national director for mental health should hold overall responsibility for the HSE’s mental health budget to enable financial accountability at national level, with executive clinical directors assuming responsibility for mental health resources within their areas.

It also recommends the implementation of a number of new performance indicators, supported by targets and associated timeframes. It says the Government should consider using the law to drive the delivery of fully staffed community mental health teams, which should be fundamental to the mental health service.

Mr O’Gorman said that the report contains solutions to the continuing problem of lack of effective reform of the mental health services.

“Irish people deserve a mental health service that not only meets our international human rights requirements but actually improves the lives of those who use it,” he said, adding that for this to happen there has to be accountability for the reform, delivery and transformation of the service.

Caroline McGrath, director of the Mental Health Coalition, said the proportion of the health budget spent on mental health was actually declining four years after the publication of A Vision for Change.

The 2010 HSE service plan allocated only 5.4 per cent of the health spend to mental health, which was a reduction on the 2009 figure, and far short of the 8.24 per cent recommended in A Vision for Change.

This failure to protect the already poor position of mental health could not be explained or excused by the economic situation, and was the result of the absence of basic and effective management systems and accountability, she said.