It is a rare and refreshing event when a statutory body bites the hand that feeds it. Such organisations worry that any blunt criticism of government could result in an undesirable backlash. But years of deliberately-ignored reports caused chairman of the Mental Health Commission John Saunders to call out the Government over its funding of unsafe and substandard services for children and adults.
The treatment of people with psychiatric problems must qualify as the longest running and least defensible of our public health scandals. Discrimination starts in early childhood, when counselling and family services are totally inadequate; to staff shortages at the Central Mental Hospital; use of prisons as dumping grounds; an increasing use of seclusion and physical restraints and the seclusion of adults with severe mental health problems in dirty, community-based residences.
These matters are well documented. But because mental illness has been such a taboo subject in Irish society, politicians have tended to look away and it has not received the necessary level of funding. Without investment and major change, the Commission declares, the level of care provided to vulnerable and distressed individuals will continue to be unsafe and substandard. Shortcomings are now so pronounced that they breach the fundamental rights of service users.
Services for children and adolescents are, the report found, inadequate, poorly funded and unresponsive to the needs of young people and their families. Care plans were mostly ‘paper exercises’ and failed to address recovery strategies. A lack of out-of-hours and inpatient services meant that children continued to be admitted to adult mental health facilities. As if that wasn’t bad enough, services for some of these challenged individuals did not improve when they grew older. It is not just a question of funding, Saunders explained, but how and where that money was spent. He acknowledged the HSE’s difficulty in recruiting professional medical staff but saw no reason why individuals in community-based residences should have to live in dirty and poorly maintained conditions.