HSE 'failures' on mental health criticised

LITTLE SUBSTANTIAL progress has been made on the Government’s plan for improvement in mental health services, an independent monitoring group has found.

The group said there was "an urgent need" for Government and the Health Service Executive (HSE) to renew their commitment to the full implementation of A Vision for Change(AVFC), the Government's plan for the mental health service in Ireland, published four years ago.

The second independent monitoring group for the plan, appointed in June 2009, published its first report yesterday. It said there had been “little substantial progress” in 2009 in implementing the plan.

More than 700 staff left the mental health services in 2009 and only 65 were replaced due to a moratorium in recruiting, it found. “This had a significant impact on the implementation of the plan.” It complained of communication issues with the HSE, saying the language it used in its reports was “frequently unclear, vague, complex and imprecise”.

“It is therefore very difficult to ascertain the precise progress to date,” it said.

It also said that despite agreed deadlines, it was still awaiting 11 local HSE reports. “The only conclusion . . . is that the HSE is either unable to provide the accurate and timely information required, or is unwilling to do so,” it said.

The report raised concerns about the funding of mental health services and said it had been reduced at a rate disproportionate to overall expenditure in the health system. It also said the group was disappointed about the little progress that had been made on the closure of old hospitals.

“There appears to be an absence of determination, leadership and understanding to ensure that the recovery ethos underpins all aspects of mental health care services,” it said.

The report suggested this could be attributed to “the disconnect between strategic thinking and operational action”, in the HSE.

It also severely criticised HSE management structures, saying many of the presentations to the group “expressed frustration about the constantly changing management structures”.

“In its discussions with various organisations, the group was constantly reminded of the lack of transparent, detailed, time-lined and costed plans for the implementation of AVFC,” it said.

It said there was an urgent need for Government and the HSE to renew their commitment to the full implementation of the plan.

This would ensure that Ireland was provided with “a modern 21st century community-based, person-centred, mental healthcare service, grounded in the principles of recovery”, it said.

Publishing the report, Minister for Equality, Disability and Mental Health John Moloney said a significant amount of preparatory work and planning had been taking place, which would show tangible progress in 2010 and 2011.

Amnesty International Ireland and the Irish Mental Health Coalition called for HSE accountability for its continuing failure in mental health.