Most mental health service users ‘do not know how to complain’

Mental Health Reform pilot study highlights ‘need for greater access to advocacy supports’

Mental Health Reform director Dr Shari McDaid. Photograph: Alan Betson

Mental Health Reform director Dr Shari McDaid. Photograph: Alan Betson


The majority of mental health service users do not know how to complain about the treatment they receive, according to a new study.

The pilot study of advocacy needs of mental health service users living in the community also found that 21 per cent of participants felt they had no say in planning their mental health treatment, while 9 per cent were not satisfied with the support offered from their mental health team.

The report by the Mental Health Reform group was compiled from surveys of 76 people in a large community health organisation area in Dublin.

Most survey respondents tended to be single, unemployed or on disability benefit and had relatively low levels of educational attainment.

When asked how comfortable they are with the thought of family members advocating on their behalf, 38 per cent said they would not be comfortable at all compared to 12 per cent, who were absolutely comfortable with such a situation.

In terms of participants’ distrust with psychiatrists, with 17 per cent said they were not at all confident in raising issues with their psychiatrist.

A majority of the 76 reported feeling that they had little or no control over their own lives, and 67 per cent said they did not know how to make a complaint about mental health services.

Only 1 per cent said they would turn to a social worker for support in getting what they needed from mental health services compared to 30 per cent for a medical professional, and a large cohort were particularly daunted about the prospect of complaining to the gardaí or HSE.

In a comments section provided on the survey, many respondents wished for a reform of mental health services.

One person said they “don’t hold out much hope of this happening”, and another referenced a lack of consistency in support services.

“Every time I go to my local psychiatric clinic to an appointment I see a different psychiatrist for no more than 15 minutes. It makes it difficult to trust and fully open up about my problems so it becomes pointless,” the person said.

In their concluding remarks, the report authors highlighted a shortfall in advocacy support for mental health service users, and said there was a clear deficit of knowledge among this cohort about where they can turn to for assistance.

Among a list of recommendations provided was the rollout of a more detailed nationwide survey into advocacy issues, and a targeted campaign by the Irish Human Rights and Equality Commission to boost mental health service users’ awareness of their employment rights under anti-discrimination laws.

The authors said there is a “critical need for the HSE to increase efforts to promote awareness” of its own ‘Your Service, Your Say’ feedback process, and encouraged mental health services to audit the level of involvement of service users in recovery and care planning.

“The significant picture that emerges from this report is that for a group of people who use mental health services in an area of high deprivation and poverty, there is a clear need for greater access to advocacy supports,” said Mental Health Reform director Dr Shari McDaid.

The report was officially launched on Tuesday by Ombudsman Peter Tyndall, and politicians including Sinn Féin deputy leader Mary-Lou McDonald and Senator Máire Devine were also in attendance.

Elsewhere, a report released by the Health Research Board on Tuesday shows that admissions for psychiatric facilities declined by almost 600 in 2016 compared to the previous year.

Overall there were 17,290 admissions to psychiatric hospitals and units last year, down from 17,860 in 2015. The 20-24 years age group accounted for the highest proportion of admissions, while the lowest rate was among those aged 25-34.

Figures for first-time admissions and readmissions both fell compared to 2015, and depression continued to be the most common diagnosis followed by schizophrenia, mania and alcohol disorders.