Our mental health services are far from divine, and anything but a comedy, says Dara Gantly
Two of world literature’s greats came to my attention on June 16 last. Naturally, James Joyce was one. Indeed, how could you miss him between all the fried mutton kidneys, Gorgonzola sambos, and dapper David Norris look-alikes (sorry, one of those was actually Senator Norris) ambling around Meeting House Square on Bloomsday. The other great man of letters was the Italian poet Dante, but he crossed my path for all the wrong reasons.
“Whereas the key ingredient in the concept of recovery is the encouragement of hope, admission to these units is more akin to the abandonment of hope as described by Italian poet Dante.” Unfortunately the above quote is taken from page 82 of the Mental Health Commission’s Annual Report for 2009, released last week, which highlighted the fact that some of society’s most vulnerable people still reside in old, unsuitable, dilapidated mental health facilities.
Comments from the medical profession on the report’s findings — and on the order by the Commission to prevent any new acute admissions to three hospitals, St Ita’s, St Brendan’s and St Senan’s — was forthright. While the College of Psychiatry of Ireland welcomed the recommendations, Dr Siobhán Barry said psychiatrists were ‘alarmed’ at the slow progress in moving from institutional care to the community — with a lot of the blame for this being placed on the moratorium on staffing.
The impact of the recommended closures also needed to be accessed and adequately resourced alternatives developed, the College added.
Even the politicians themselves did not seem to be putting a spin on things. Minister of State John Moloney acknowledged that overall the pace of change towards a “modern, patient-centred, recovery orientated mental health service” was slow. Perhaps ‘painfully slow’ would be more appropriate.
We are now in year five of the implementation of A Vision for Change, and Chairman of the Mental Health Commission Edmond O’Dea is right when he says it is alarming to see how the ambitions for reform of our mental health services have slipped. And he is not alone.
Orla Barry, Director of the Irish Mental Health Coalition, believes we have reached “crisis point”, with the HSE clearly not delivering on its promises. Colm O’Gorman, Executive Director of Amnesty International Ireland, said the continued failure to improve mental health services was a “stain on Ireland’s human rights record”.
As reported last week in Irish Medical Times, the HSE was 24 per cent (€1.513 million) below profile spend in mental health for the first quarter of 2010. It put much of this down to the ‘big freeze’, which impacted on construction progress.
A Vision for Change — which heralded a new dawn for the mental health services in Ireland — recommended that the resources released by the closure of all psychiatric hospitals should be re-invested in the mental health service. This needs to be reexamined in the light of the property crash, as having a five-year capital programme is really of no use if it isn’t going to be implemented. Perhaps we need to look at an alternative revenue source?
Joyce — whose daughter, Lucia, suffered from mental illness — could see what could be achieved in one June day, so five year’s should be enough for the Government and the HSE to deliver on its promises.
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