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

The Psychiatric Nurses’ Association said services had been allowed to go into “freefall” in recent times, with hundreds of nurses retiring this year and not being replaced. An independent monitoring group established to oversee the implementation of A Vision for Change this year said progress was “slow and inconsistent”. It estimated there were some 1,500 vacant mental-health posts.

Serious concern

Internal records show serious concern at how the “floor” of staff to run services is falling and funds are leaking out into other areas of the health budget. One Health Service Executive document states that even though there is an exemption on the recruitment moratorium for psychiatric nurses it “could not be implemented as services could not retain the resources to fund the replacement posts”.

There are also signs of significant pressure in some parts of the country. The clinical director of mental health in the Louth-Meath area warned in an email that already stretched services were being “decimated”.

“With the huge exodus of nurses who are retiring, coupled with the recruitment embargo, the community services of which we are so proud are being decimated,” she wrote.

“Nurses from the home base, assertive outreach and community mental health are being pulled in to cover the 24-hour residences.” She added that the region did not have any rehabilitation, addiction or mental health services for people with an intellectual disability.

This, too, was the theme of a recent report by the Inspector for Mental Health Services. It expressed extreme concern for the welfare of intellectually disabled residents at a facility in Wexford who have been deprived of essential therapies.

“It was evident from observing the residents that maladaptive behaviours, self-stimulation, institutionalisation and withdrawal were prevalent, all issues that could be addressed by providing appropriate therapies and an appropriate environment,” inspectors said.

Government commitment

What is the future, then, for our embattled mental health services? The Government points to the fact that another €35 million in development money has been set aside for mental health during 2013 as a sign that it is fully committed to modernising this neglected quarter.

“In these difficult times, it is vital that our mental health services continue to be developed in line with the blueprint set out in Vision for Change,” Minister of State with responsibility for mental health Kathleen Lynch said. “This funding is a demonstration of this Government’s commitment to protect the most vulnerable.”

She pointed out that many of the 414 staff due to be hired during 2012 were being hired. For example, 270 of the promised posts have been accepted and appointments are proceeding.