Mental health services – signs of change


Sir, – Mr John Farrelly, chief executive of the Mental Health Commission, is correct that more needs to be done to improve mental health services (“Legacy of disrespect lingers in our mental health services”, Opinion & Analysis, December 27th). There is a global dimension to this issue. The World Health Organisation reports that, despite depression being the world’s leading cause of disability and 800,000 people dying by suicide annually, most people affected by mental illness – 75 per cent in many low-income countries – do not get the treatment they need. In addition, people with mental illness are at increased risk of unemployment, homelessness and imprisonment in many countries, including Ireland.

But there are reasons for optimism. Globally, suicide has fallen by 38 per cent since 1994 and many countries are stepping up to the challenge of mental illness in new and positive ways. In May 2018, India granted a legally binding right to mental health care to all of its 1.3 billion residents – one sixth of the planet’s population. Given the under-resourcing of services in India, the challenge is certainly great, but the vision is greater still.

In Ireland, too, rates of suicide are falling and our 2006 mental health policy, A Vision for Change, is currently being updated. The Mental Health Act 2001 is also being revised, to place greater emphasis on human rights. In March 2018, we ratified the UN Convention on the Rights of Persons with Disabilities, and we are introducing new mental capacity legislation to provide greater voice to people with disabilities, including those with long-term mental illness.

Yes, we need to do much more, but there are signs of positive change. In the words of Martin Luther King, “the arc of the moral universe is long, but it bends towards justice”. – Yours, etc,


Department of Psychiatry,

Trinity College Dublin,

Dublin 2.