Slow progress in mental health service as tide goes out on Victorian-era hospitals

Many patients say an understaffed community mental health service has left them isolated and disempowered

Miriam O’Shea was looking for help. She had spent several months in a psychiatric hospital, where she was treated for bipolar disorder. But after she was discharged and looked for support in the community, she felt she couldn’t find any.

“Drugs work for some people but for me they just numb my emotions,” said O’Shea, who left hospital last February.

“I needed the kind of peer support in the community and the kind of therapy that treats you as someone with emotional and spiritual needs. I couldn’t find any of that . . . All I was being offered was medication and more medication.”

Under a seven- to 10-year Government policy to modernise the State’s mental health service, old-style Victorian-era psychiatric hospitals are being closed down and replaced with community mental health teams.

Slow progress

These teams are supposed to offer a range of treatment options, such as talk therapy, that promote a recovery-based approach to mental ill-health, replacing an increasingly outmoded and heavily medicalised approach. But, seven years after A Vision for Change was published, progress remains slow. Few parts of the country have a fully staffed community mental health team. In fact, just 17 out of a promised 414 staff due to be appointed to these teams and other services were hired and in-post during the year.

In the meantime, some regions say they are pulling their professionals out of the community and filling gaps in inpatient hospitals or residences.

The result is an understaffed community mental health service many patients say is leaving them isolated, disempowered and starved of meaningful treatment options.

There is little doubt that the recession is bad for people’s mental health. A recent study published in the British Medical Journal, for example, found levels of stress, anxiety and mental ill-health have risen significantly since the start of the economic crisis.

“The onset of the global economic downturn, heralded by the collapse of Lehman Brothers in September 2008, can therefore be considered as a potential threat to public health,” according to the research.

The same seems to be happening here. Last year at least 525 people took their lives in the Republic, a 7 per cent increase between 2010 and 2011. Nearly 10,000 people reported to hospital with self-harm, a 4 per cent increase during the same period. It was the fourth successive annual increase recorded. In the meantime, the rate of first admissions to inpatient psychiatric units increased by 5 per cent in 2010.

Just when mental health services are needed most, however, many claim they are fraying.