Mental health: Prioritising a real need

Evidence of a dysfunctional system of care that heightens risk for the vulnerable

Suicide is the leading cause of death among young people but statistics cannot convey the devastation and heartbreak of affected families or the impact these deaths have on local communities. Prevention may not always be possible, but early intervention and care by mental health professionals offer the best hope of escape from depression and despair. In spite of that and an official policy entitled Vision for Change, the Health Service Executive has regularly diverted supposedly "ring-fenced" funding to other areas while mental health services stagnate.

A report from the Psychiatric Nurses Association and the Royal College of Surgeons provides evidence of a dysfunctional system. Policy aims are not being met within community structures, we are told, while best practice is only an aspiration. The quality of mental health services and care is inadequate and the operation of crisis facilities is chaotic. A recent finding by the Mental Health Commission that fewer than 10 per cent of mental health facilities meet all legal requirements confirms this. Even more distressing, the MHC found that half of all patients were being "kept in seclusion" in a way that posed a risk to their safety and welfare.

What does it take to shake politicians and officials out of traditional mind-sets and promote mental health and the care of those in distress as a priority? Some €35million a year is ring-fenced for the development of mental services and recruitment of staff but much of this money has been used to plug holes in acute hospital services. It is the ultimate in short-term thinking. This year, money for recruitment was again diverted and returned only when the HSE was granted an additional €500million for other services.

The Government has given a commitment to implement Vision for Change, subject to a review. That caveat is a cause for concern because of the lack of urgency shown in developing community-based services and providing specialist intervention for children and adolescents. Where funding is concerned, the needs of individuals at risk should outweigh promised tax cuts.