Delivery of mental health plan 'slow and inconsistent' - report

DELIVERY OF the State’s key mental health plan, A Vision for Change, has been “slow and inconsistent” a new report has found.

The 2011 annual report by the independent monitoring group on the A Vision for Change strategy identified major staffing problems in the mental health services.

This was the final report of the group chaired by John Saunders, the director of mental health support organisation Shine.

Mental health services had taken a “proportionally much greater reduction in staff numbers” than other areas of the health service, submissions to the body had said. The public service recruitment embargo made it “extremely difficult” to change mental health services as per the plan, the report said said.

There were some 1,500 vacant posts in community health teams which were “poorly populated”, it said. There had been “very slow progress” in fully staffing community metal health teams, it found.

Distribution of staffing in mental health services was “haphazard and uneven” due to the “unpredictability” of retirements and resignations, it said.

Staffing at residential units for children and adolescents was lower than in 2010, at 64 per cent of the recommended level compared with 70 per cent in 2010.

Problems with the expected capital investment in mental health from sales of unrequired lands, were identified in the report.

Such investment “failed to materialise” despite a commitment to allocate up to €50 million per year from the sale of land. Due to the property collapse, a total of €37 million was recouped from the land sales, it said.

Mental health expenditure was 5.3 per cent of the health expenditure far short of the 8.4 per cent figure in the State’s plan, it said.

It noted that the additional allocation of €35 million for filling community mental health teams meant the budget was still 1 per cent down on 2011.

A lack of progress in developing specialist mental heath services was identified by the group.

There was a “worrying absence of development” of appropriate services in areas such as intellectual disability, old age and eating disorders, it said.

It also pointed to an absence of a recovery ethos and a lack of staff in this area. There was a reactive rather than proactive approach to the needs of patients and families.

Welcoming the closure of outdated hospitals it raised concerns about new community-based mental health units becoming “miniature institutions”.

The absence of an implementation plan for the mental health plan was a “significant barrier” to its full implementation, it said.

The group called for a national mental health service directorate to be of “central importance” in the modernisation of services.

The creation of a directorate was announced by Minister for Health James Reilly in May with legislation to allow for the appointment due to be published today.

Fine Gael TD for Limerick Dan Neville welcomed the legislation as “ensuring that this role will be filled sooner rather than later”.