Mental health body criticises progress

The State's watchdog on mental healthcare has expressed concern at the slow pace at which health authorities are working to implement…

The State's watchdog on mental healthcare has expressed concern at the slow pace at which health authorities are working to implement a national policy on developing mental health services.

At its first annual conference yesterday, the Mental Health Commission said key parts of A Vision for Changeblueprint were still not in place almost two years after the policy was accepted by the Government.

Speaking at the commission's first annual conference yesterday, Dr Edmond O'Dea said there was an "apparent tardiness" in the failure to establish a national mental health service directorate, a body considered key in managing the changes contained in the new policy.

While he said funding for developing mental health services had increased in recent years, it still accounted for less than 8 per cent of overall health expenditure.

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The Health Service Executive's "prioritised implementation plan" for A Vision for Changehad still not been published, although Dr O'Dea said he understood this would be available in the coming weeks.

Yesterday's conference focused mainly on the effects of the Mental Health Act (2001), which came into force in November of last year. The law provides for greater protection of patients' rights, especially in the area of involuntary detention.

The number of patients admitted to psychiatric hospitals against their will has fallen by almost one-quarter since the new law came into force.

The commission says there were 1,582 involuntary admissions to psychiatric hospitals during the first nine months of this year, compared to the same period in 2005.

The Mental Health Act prohibits people with personality disorders or drug addictions from being classified as having a mental disorder.

Research conducted in recent years suggested that about 14 per cent of all involuntary admissions had a diagnosis of personality disorder, alcohol disorder or drug dependence.

Dr O'Dea, who welcomed the overall reduction, said: "The provisions of the Mental Health Act have made an important contribution to this reduction. However, we also know that the availability of comprehensive community-based and accessible mental health services reduces the prevalence of involuntary admissions."

He said the full implementation of A Vision for Changeand the commission's new quality framework would ensure that high-quality services are available within the community.

The commission also expressed concern at the proportion of applications for involuntary detention being initiated by gardaí.

Figures show that the proportion of applications initiated by gardaí has doubled from about 8 per cent in 2002 to 16 per cent this year.

Mental health campaigners say "authorised officers" are better-placed to consider such applications given that they are trained to offer support in a crisis; provide information to users, carers and relatives; and examine the least restrictive options.

Dr O'Dea said the commission felt the development and expansion of the authorised officer system was an urgent priority. These officers may be HSE employees such as local health managers, psychiatric nurses, occupational therapists, psychologists or social workers.

"International research tells us that the level of co-operation between the police and the mental health services is a key factor to ensuring effective support and intervention for people with a mental illness in crisis," Dr O'Dea said.