Early intervention is crucial in the successful treatment of illness and this applies particularly to mental health. The latest figures from the Health Service Executive (HSE) show hundreds of children and adolescents, mainly from western and southern counties, have been waiting for more than a year for a specialist appointment.
Head of mental health services at the HSE Martin Rogan, put it bluntly in an interview with this newspaper: “When you give resources, you get good outcomes. When you deny resources you get late interventions. You get people who are already severely labelled who will end up having a lifelong mental illness that could have been avoided.”
That appalling reality has been ignored by too many governments. Early interventions rarely happened; services were starved of resources and a hospital-based system entombed up to 20,000 people. In recent years, efforts have been made to provide services within the community and some limited progress has been made. The existing programme for government pledges to “vastly improve access to modern health services in the community” and to ring-fence €35 million annually for the development of community mental health services.
As happened on previous occasions, however, some of the promised funding was used last year to plug a hole in the HSE’s finances and additional staff numbers did not materialise. Since then, Minister of State Kathleen Lynch has said the required staff would be employed early this year. But the gaps that exist, in terms of community facilities for both young and older citizens, will be difficult to bridge.
Last year, new inpatient units for young people opened in Dublin, Cork and Galway. Despite that, up to 100 young people were detained in adult psychiatric units, a practice that has been severely criticised by the Mental Health Commission.
Such forced detention in adult units may scar a young person for life. In addition, the inherent stigma may affect their employment prospects and relationships with their peers. Mental illness still generates a negative social response, particularly in rural areas where help is least likely to be available.
The establishment of drop-in youth centres, such as Jigsaw, allows for early, appropriate discussion and intervention in a non-threatening setting. However, progress in providing such facilities is painfully slow, even as the rate of suicide among young people and adults continues to rise.
Everybody is aware of the Government’s fiscal difficulties. But failure to provide vital mental health services within the community cannot be tolerated any longer.
At the very least, additional staff and development funding must be provided. It makes long-term social and financial sense.