More aftercare needed for mental health patients, public consultation told

‘There was no plan in place, only to attend the clinic in my local primary care facility’ inpatient says of discharge

People who have used mental health services in Ireland say that more resources are needed for their aftercare upon discharge, according to submissions from the public consultation on reviewing the Mental Health Act. Photograph: iStock

People who have used mental health services in Ireland say that more resources are needed for their aftercare upon discharge, according to submissions from the public consultation on reviewing the Mental Health Act. Photograph: iStock

 

People who have used mental health services in Ireland say that more resources are needed for their aftercare upon discharge, according to submissions from the public consultation on reviewing the Mental Health Act.

One hundred submissions were made between March and April, and they came from people who have used mental health services, their family members, NGOs and healthcare providers.

In July of this year, the Government approved the draft general scheme of a Mental Health (Amendment) Bill, to update the Mental Health Act.

The Department of Health said the draft was informed by the submissions, which were published on Tuesday.

One person who was an inpatient said there was not adequate care upon their discharge.

“There was no plan in place, only to attend the clinic in my local primary care facility. I thought that there would be organisation of a support person or of classes that I could do in the community. I was very much mistaken.”

They said any classes or therapies they wished to attend had long waiting lists or were not accessible.

The person also said their family, whom they lived with, were not supported enough, and they were not given their diagnosis until they asked for it.

Another person said that they were involuntarily detained over ten years ago due to an adverse reaction to an SSRI drug.

They said they were traumatised by their experience, and that their detention “felt like something out of the dark ages or 1970s Ireland.”

They spoke about the loss of their teaching career, and how the term “voluntary” was redundant in practice.

“In my notes it says that I was voluntary but if I insisted on leaving the hospital I should be detained and regraded to involuntary. The system seems to have taken the word ‘voluntary’ and reinvented it.”

Another person spoke about how their daughter was forced to seek treatment in Dublin, over 80km away for the family home.

She also said that her daughter had to fight to stay within services once she turned 18. “As an adult on her first appointment at the adult services she was told she would be transferred back to her GP. It was as though her history didn’t exist.”

A number of submissions from psychiatrists, doctors and other healthcare workers expressed concerns about some of the Expert Group’s recommendations on updating the Mental Health Act.

In particular, concerns were raised about changing the criteria required for involuntary detention. Some submissions stated this may result in a deterioration of the mental health of patients who experience psychosis, to the point where they become engaged in the criminal justice system.

Potential delays to treatment as a result of any changes to the act were also raised as a concern, as was some patient’s ability to consent to treatment, if they did not accept or understand the extent of their mental illness.

Advocacy groups for people with disabilities, the LGBTQ community and groups representing Travellers also made submissions, saying that the specific circumstances of these marginalised groups should be considered when it comes to mental health treatment.

According to the Department of Health, over half of the submissions provided views on advocacy.

The Department said in the new updated act, a person will have a statutory right to engage with an advocate, and if they consent, information on their treatment can to be given to family members.

The Department said it will now work with the Office of the Attorney General to draft the Mental Health Bill, and the general scheme of the bill will be subject to pre-legislative scrutiny by the Oireachtas Committee on Health.