There is "no will" by the health services to provide an adequate service to people with an intellectual disability who have mental health problems, a report published today says.
The annual report of the Inspector of Mental Health Services for 2006 is again highly critical of some of the services offered for people with mental health difficulties, although it acknowledges a "change in thinking" on how mental health services should be delivered.
Dr Susan Finnerty
According to the report by Dr Susan Finnerty, published by the Mental Health Commission, the only mental health services for people with intellectual disabilities are delivered by consultant psychiatrists.
"There are no multidisciplinary teams, no social workers, no occupational therapists, no speech and language therapists, only a handful of community mental health nurses, and no psychologists," the report states.
"In Louth, Meath, Cavan and Monaghan there is not even a consultant psychiatrist. There are only three or four psychiatrists specialising in mental health in children with intellectual disability."
In addition, the report notes an "almost complete absence" of in-patient services for people with an intellectual disability with a mental disorder who require such treatment.
"It can only be concluded that these patients are receiving treatment in units that are not approved and that they are not protected by the Mental Health Act, 2001," Dr Finnerty says.
Her inspectorate recommends the establishment of multi-disciplinary health teams and the provision of appropriate in-patient units.
"However, report after report has highlighted this serious deficit and the Inspectorate can only conclude that there is no will to provide an adequate mental health service to this group of people."
Dr Finnerty says that over the past three years, the Inspectorate has noted a change in thinking about how mental health services should be delivered.
She said she expects that each in-patient will have a multidisciplinary care plan by the end of 2007.
"There are plans to close most of the remaining old psychiatric hospitals, some plans more advanced than others. There are still large numbers of patients in long-stay wards living in unacceptable conditions, without recreational or therapeutic activities or care plans. The Inspectorate remains deeply concerned about these vulnerable people and will continue to monitor the care and treatment of these patients throughout 2007."
HSE statement
Dr Finnerty also says the lack of coherent overall plans for services over the next five years is "worrying".
"The ad hoc nature of mental health provision has been noted in the past and there is no sign currently that this situation will change. There is genuine frustration and disillusionment from those delivering the service at their lack of information and participation in planning."
In a statement, the Health Service Executive (HSE) welcomed the report and said it demonstrated "progress made towards modernisation of mental health services and provides an independent perspective on where services may need to be further developed".
The HSE said last year was "particularly significant" for mental health services in Ireland, with full implementation of the Mental Health Act 2001 and the publication of the new Government policy document on mental health, A Vision for Change.
"In order to meet these new requirements the HSE will be investing an additional €25 million in services and will employ another 250 new staff members in 2007, as well as investing €796 million in capital infrastructure over the coming years."