11th July 2012
In December last, I praised the budget 2012 commitment to invest €35 million in mental health services, of which €23 million was dedicated to developing community mental health teams for adults and children.
Along with many others with an interest in mental health, I was alarmed to read in a newspaper report over the weekend in The Irish Times that part of the €35 million investment in mental health services could be used to offset overruns in the HSE. This report was swiftly countered by the Minister of State’s Cabinet colleague, the Minister for Public Expenditure and Reform, who gave assurances on the RTE Radio 1 programme “This Week” on Sunday that the promises of additional posts for mental health services would be delivered. My first request is that the Minister of State take this opportunity to give me the same assurances in this regard.
In budget 2012, a further commitment was made to recruit 414 staff for community mental health teams, of which 250 posts were to be in dedicated adult teams. I am extremely disappointed that not one position has been filled although it is now July 2012. The Minister of State is, more than most, acutely aware of the wide-ranging benefits of community-based mental health services. Among many other benefits, community-based mental health services enable people to be treated for mental distress in their communities, either at home or in a hospital, minimise inpatient and day-case hospital stays, liaise with local community services such as vocational training, education, housing and voluntary support services to provide integrated recovery support for the individual, and support primary care staff in providing mental health support. Furthermore, having accessible mental health services in the community can help normalise mental health and destigmatise mental health problems, reducing the prejudice and discrimination that people currently face. Community mental health teams are a vital part of the recovery ethos which is central to A Vision for Change. The community-based mental health services envisaged in A Vision for Change are specialist services with staff who have particular expertise in supporting people’s mental health.
Core services offer a holistic range of supports and include staff from a range of specialist disciplines such as clinical psychology, mental health nursing, occupational therapy, psychiatry and social work. However, the specialist disciplines mentioned remain significantly understaffed. Back in 2010, a report by the Inspector of Mental Health Services on an audit of community health staffing showed that only 50% of the required number of psychologists and only 60% of the required number of occupational therapists were in place.
In addition to my concern about the existing under-staffing, I am concerned by reports from the coalition group Mental Health Reform that the Irish Mental Health Commission is no longer collecting data on staffing levels in approved centres. This gap in data will make it extremely difficult to assess whether staffing levels are reaching the recommended level as set out in A Vision for Change. My second request is that the Minister of State tell us what information has she in this regard. Perhaps she can provide me with assurances that data will be collected.
The Minister of State recently confirmed that 31 of the promised 414 posts in community mental health teams under the HSE service plan 2012 will be converted to nursing posts for acute inpatient services in Dublin-mid-Leinster region. Mental health services in Ireland have for far too long been the Cinderella of the health services. The 414 staff promised in the HSE service plan should not be deployed in inpatient services and must remain in the community. Staffing needs to be ring-fenced. The continuing uncertainty over the future of the mental health budget does nothing to allay fears about the Government’s commitment to invest the dedicated €35 million I mentioned at the start. My third and final request is that the Minister of State confirm that the badly needed posts in community mental health teams will be in place by September, and that the posts will be ring-fenced to ensure they are not diverted to inpatient services.