THE STATE’S flagship plan for reforming mental health services is making slow progress due to a lack of financial resources, a moratorium on staff recruitment and a lack of dedicated corporate leadership, a new report has warned.
The 2010 annual report by the independent monitoring group on the A Vision for Changestrategy said mental health services are suffering disproportionate losses in posts, compared to other parts of the health service.
It said 1,000 registered psychiatric nurses retired during 2009 and 2010. A further 1,100 will be eligible to retire by 2012, said the report, which recommended continuing the current derogation on the recruitment moratorium for psychiatric nurses.
Staffing shortages have resulted in little progress being made in the plan to establish fully staffed community mental health teams or specialist mental health services.
This lack of development undermines significantly the full implementation of the model of service described in A Vision for Change, according to the report.
A Vision for Changewas published by the previous government in 2006 as its plan to modernise antiquated mental health services in Ireland. It aims to establish 99 community teams across the country and recommends appropriate staffing levels across all mental health services.
The monitoring report welcomed progress in the development of new youth and adult inpatient units in Dublin, Cork and Galway and the imminent closure of outdated mental health units in Wexford, Dublin, Tipperary and several other areas.
It also welcomed the commitment made in the budget to reduce spending on mental health services by 1.8 per cent, proportionately less than the cuts to other health services.
But it said there had been a lack of progress in developing important specialist services such as forensic mental health care services, rehabilitation and recovery, eating disorder services, psychiatric services for older people, services for co-morbid severe mental illness and substance abuse problems and, in particular, intellectual disability services.
“There is now a critical and urgent need for Government to turn its attention to these specialist services used by some of the most vulnerable people in society.”
The report said the delay in the introduction of services had been contributed to by a failure since 2007 to allocate some €21 million in anticipated development revenue to implement the plan.
The monitoring group welcomed the development of the capital development scheme, whereby €50 million per annum is to be made available from the sale of old psychiatric hospitals and lands.
However, it was disappointed the changed economic environment meant it was difficult to realise the full potential of the scheme.
The report highlighted a lack of dedicated corporate leadership in the service. It said there was an urgent need for a full directorate of mental healthcare services with the director reporting directly to the chief executive of the Health Service Executive.
This directorate must have authority in reconfiguring existing services and the development of new mental health care services.
The lobby group Mental Health Reform said the report demonstrated the need for the Government to resuscitate the A Vision for Changestrategy.
“If staff losses continue, safe services cannot be guaranteed for much longer. Mental Health Reform is calling on the Government to provide its commitment to mental health services reform by preserving the funding for any mental health post lost in 2011 and use it to recruit multidisciplinary staff to develop community-based mental health services,” it said.