Emergency services for people in the Republic who are going through a personal crisis which could result in them taking their own lives are "lacking or gravely deficient", according to a report out today.
The report for the Mental Health Commission, which is based on a survey of adults using public sector mental health services, found people can be waiting months for help even when they are in deep crisis. One person interviewed told of requesting to see a specialist in February, only to find nobody was available until September or October.
Another individual surveyed indicated they were "very bad" in May when they asked to see a psychiatrist. The patient was told they would have to wait until August. "And then in August they said to wait another month," the patient recalled.
The report, The Views of Adult Users of the Public Sector Mental Health Services, says that sooner or later the person in crisis will be unable to tolerate hours of waiting time at a clinic or in an A&E unit, or the months of waiting for an appointment with a counsellor or psychotherapist. "Concern about suicide and its prevention must be backed up by accessible and fast-responding services on the ground," it adds.
Carried out by Dr Elizabeth Dunne from the department of applied psychology at University College Cork (UCC), the report also finds there is an over-reliance on medication as the only treatment for mental health conditions.
A number of service users complained that side effects of medication were not always discussed or taken seriously by their consultant. They felt many doctors had little or no interest in working with them to reduce their dosage.
Some service users also had mixed views on how they were treated by GPs and nurses, with both groups receiving positive and negative feedback.
The report says non-pharmacological interventions must become as routine as drug treatments. It said the present system has to change whereby people using public mental health services cannot choose or change their consultant or therapist.
Those who had been admitted involuntarily to psychiatric hospitals recalled the experience as "traumatic" and involving "inordinate force". Once inside there was a lack of privacy, exercise and fresh air, and a lack of things to do if one didn't smoke or watch TV.
Outpatient services also came in for criticism because they provided insufficient time for consultations and often several patients were given the same appointment time.
Dr Dunne said mental health services needed to be easy to access at local level and offer immediate help. She said mental health required more funding: "It really needs to have ringfenced funding so that it's no longer the Cinderella of the health service."
What some users said
"That first meeting with the mental health services took so long . . . The system has no format for early intervention . . . If this illness is tackled at the early stages, it will not develop into what it does."
"It is very seldom that you would see your consultant at outpatients' clinics. It is usually a junior doctor and a different doctor each time. No continuity at all."
"I had to go private. There was too long to wait [ to access psychological therapy through the public health system]."