Putting the person first in mental health policy

According to Dr Don Berwick, co-founder of the Institute for Healthcare Improvement, care can be described as person-centered if the needs of the individual requiring care comes first. What this means is that in the first instance, collaboration takes place between the person and the caregiver. It means transparency, choice, dignity and respect is given to each person on an individual basis and the service becomes one that empowers patients through access to information, choice and accountability.

“Mental health is such an important issue,” says human rights campaigner Fr Peter Mc Verry. “But it is a marginalised issue, within the health system and within society.” Given the importance of good mental health, and given the fact that it has somewhat been marginalised within the health system, it is worth taking a closer look at some of the innovations and initiatives happening within Ireland’s mental health system today.

Mental health in Ireland

Orla Barry is CEO of Mental Health Ireland (MHI), the national umbrella body for 92 local mental health associations throughout the country. “Mental Health Ireland was established in 1966 so our history and evolution reflects what’s happening within the mental health services. What is happening is a move over time from the psychiatric institutions to community services and a greater focus on the mental health of the whole community.”

Daragh Connolly, president of the Irish Pharmacy Union, feels that pharmacists are one such profession that can intervene early to assist in the promotion of good mental health at community level. “While pharmacists are the acknowledged experts on drugs and drug therapies, pharmacists can play a role in the destigmatisation of mental health also,” he says. “Our accessibility to people means that we strike up conversations with people about their health in general. This rapport can open the door to conversations about mental health. For example, a simple request for a ‘pick me up’ or ‘something to help me sleep’ can sometimes be a symptom of something else.”

In relation to specific community-based initiatives and interventions, Orla Barry describes the Gateway project in Rathmines and Áras Folláin in Nenagh as examples of consumer-led community services in the MHI network. “Over the last 10 years both projects have grown from small initiatives to become established Peer Support Projects providing a valuable service to people with mental health difficulties in local communities. This is about people supporting each other and in both projects the recovery principles of hope, choice, partnership, listening and social inclusion are very evident. Get Together Inishowen, the Kerry Peer Support Network and Troy MHA are newer initiatives all involving people supporting each other within their local community.”

Improve service

Regarding ways in which advancements in technology can empower patients going forward, Richard Corbridge, CIO of the HSE, speaks of major developments currently under way which will improve service. “The work being done to create a digital fabric for health through the EHR delivery, eReferral creation and access to information digitally will go a long way to delivering a service that empowers the service user. The public expect services to be delivered digitally and why should it be any different when it comes to health.”

But these advancements are taking place in the context of mental health still being an issue that is stigmatised, warns Peter McVerry. “Unless we address that issue of stigma, mental health will always be a marginal issue.”

Orla Barry shares this concern. “The mental health of the nation must be a priority for this new government. I am greatly concerned that diverting part of the mental health budget gives a message that mental health is no longer a political priority. Our specialist mental health services such as the Community Mental Health Teams, hospital services, Child and Adolescent Services, Psychiatry of Old Age are not yet fully in place throughout the country. In tandem the development of mental health promotion, suicide prevention and counseling in primary care all need significant development.” See futurehealthsummit.com

Anne McCormack is a psychotherapist accredited to FTAI & ICP, annemccormack.ie