Gap in mental health service provision

Sir, – The proposed changes to mental health legislation have been the focus of considerable debate in your pages over recent weeks. One crucial issue that has not been addressed in the commentary to date is the important role of interventions which minimise the need for inpatient and involuntary care in the first place. The experience of acute psychosis is the most frequent trigger for involuntary admission to inpatient care under the provisions of the current Mental Health Act (2001).

A systematic review just published in the Lancet has once again established the importance of family psychoeducation as a highly effective intervention to decrease risk of relapse in psychosis.

From 2010, the HSE had been to the forefront of innovative practice in the field of psychoeducation, as an active partner with the Eolas Project (a consortium of peers, clinicians and agencies working in the area of mental health) in the development of comprehensive information and learning programmes for people with first-hand experience of psychosis, and for their families and supporters. The Eolas programmes have proved to be highly effective in meeting the information and support needs of participants around the country, as demonstrated in an extensive series of peer-reviewed evaluation reports published by researchers in the faculties of nursing and midwifery and of psychology at Trinity College Dublin.

To the dismay of service users and families up and down the country, the HSE has inexplicably withdrawn funding from the Eolas programmes for the past three years, leaving a vital gap in service provision to service users and families and thereby increasing the risk of relapse of psychosis and potentially the need for involuntary care. During this time, the HSE has not provided alternative high-quality, comprehensive and evidence-based programmes to meet these needs, and indeed the only action taken by the HSE has been to publish a tender recently for completion of a further literature review on the topic. As this is merely a first step, it appears that the HSE is intent on wasting further time, effort and public funds in a laborious and time-consuming process of “reinventing the wheel”, instead of getting on with the job of providing the existing programmes which have already proven so effective. Is it too much to expect accountability and transparency from the HSE in relation to these mystifying decisions, which have already had such a negative impact on a vulnerable group in our community who, even in 2022, struggle to have the voices heard and support needs met? – Yours, etc,



Eolas Steering Committee,

Celbridge Health Centre,


Co Kildare;


Service User



Family Member




National Eolas



Eolas Research Lead.