TDs call for new HSE director for mental health amid expected surge in demand

Calls have been made in the Dáil for the appointment of a HSE national director for mental health to “bang the drum” for the “Cinderella” of the health service, amid an expected major surge in Covid-19-related demand for mental health and psychiatric services.

Government and Opposition TDs have warned that preparations need to be made for a post-Covid world and that a new director is urgently needed to work on an overall plan for the psychiatric “fallout” when the pandemic is over.

A director for mental health services was in place until 2016, when the role was subsumed into community health services in a restructuring process.

The Coalition’s programme for Government contains a commitment to reinstate the position, but concerns have been raised about a lack of urgency in filling the role.

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Speaking in the Dáil, Fine Gael TD Colm Burke said that "we may resolve the Covid issue in the next seven, eight months, but we are still going to have fallout from this", when there will be a "far higher level of requirement for mental health services".

Mr Burke said a director for mental health would also be able to oversee a national review of mental health facilities for the purposes of refurbishment, which he said was greatly needed.

The Cork North-Central TD pointed to a psychiatric unit in Portlaoise where nine of the 27 residents died last year due to Covid, and said this was partly because there were six residents to each room there, which made it impossible to control the spread of the virus.

Since then the unit has been upgraded and full refurbishment will take place, but there had to be a national review with a clear schedule for the upgrading of such facilities across the country over the next five years, he said.

Mr Burke added: “We need to do a lot more of that kind of planning rather than ‘filling a pothole here, and a pothole there’ kind of stuff.”

Mental health budget

Sinn Féin TD Mark Ward highlighted concerns about the budget for mental health, which he said had fallen from 16 per cent of the health budget in the 1980s to 6 per cent in 2019. An additional €4 billion for health was announced in the latest budget, but he said just 1 per cent of that would go to mental health.

The Dublin Mid-West TD pointed out that the Sláintecare health strategy recommended that 10 per cent of health funds should go towards mental health, while “international best practice” puts the allocation at 16 per cent.

Mr Ward added: “Mental health services seem to be the very definition of a Cinderella service, and without mental health, there is no physical health.”

The Minister of State for Mental Health, Mary Butler, told the Dáil she was "very supportive" of appointing a new mental health director and would be talking to the HSE about it "in the next couple of weeks".

She also said a national review of bed capacity in mental health services would be undertaken shortly and €6 million had been allocated for the upgrading and refurbishment of a number of mental health facilities. However, she said “I take on board” the points about mental health facilities nationally.