A "complete and fully independent" evaluation of both acute and community mental health services in the west has been called for by Independent TD for Roscommon/South Leitrim Denis Naughten, following confirmation that the Government's Vision for Change strategy is not being implemented in Galway and Roscommon.
A report into community mental health services in the two counties, published on June 28th, found they were still operating to 30-year-old Planning for the Future guidelines.
"The Galway and Roscommon catchment areas did not prepare any written strategy or plan for service change following the publication of Vision for Change in 2006," says the report published by HSE West.
It found that there had been no establishment of structures for the community-based approach advocated by Vision for Change, in contrast to Cavan-Monaghan where it is being implemented.
The study group, chaired by former HSE area manager for Sligo/Leitrim/West Cavan Pat Dolan, involved former Mental Health Commission chairman and consultant psychiatrist Dr John Owens and Sligo/Leitrim consultant psychiatrist for rehabilitation and recovery, Dr Mike Reilly.
It focused on one aspect of provision in the two counties, and was published a week after the Mental Health Commission reported that staff shortages and slow implementation of change across the State stopped progress in some areas.
It was published days before the Psychiatric Nurses Association (PNA) picketed University Hospital Galway (UHG) about "dangerous" staffing levels in its acute psychiatric unit.
Mr Naughten said a fully independent evaluation would help to establish the facts about mental health provision in the west region at a time when the HSE and the PNA were presenting "two very different scenarios", and where there was a failure to adequately communicate the progress or otherwise in relation to Vision for Change.
The controversial closure of the psychiatric unit in Ballinasloe, east Galway, justified by HSE West as part of the Vision for Change policy, had been very badly handled and had placed additional pressure on the existing acute unit at UHG, he said.
“This closure took place before community services were put in place to replace it,” Mr Naughten said.
“ People need to see that community resources are up and working, and are effective, before there can be any closures or changes to existing provision.”
Mr Naughten said that while Vision for Change was now Government policy, one aspect of it troubled him in that it still placed people with mental health issues in "geographic silos".
The review of services in Galway/Roscommon by HSE West said modernisation “should place little financial burden,” as they were “well endowed financially” at €220 per head of the population, compared with an estimated national mental health expenditure of €174 a head, and €144 a head in Cavan/ Monaghan.
The study found that the advanced age of people in community residences, most of whom had been relocated from large institutions, suggest the “physical problems outweighed the mental health problems”, and these people were “more in need of physical care rather than psychiatric intervention”.
Minister of State with responsibility for Mental Health Kathleen Lynch has acknowledged that Vision for Change would not be implemented in full during this Government's term, emphasising that change had to be "very carefully and sensitively handled".
