You may have heard reports that almost a third or €12 million of the €35 million ring-fenced for development of mental health care in budget 2016 is being diverted to other areas of the health service.
For those of us who have been campaigning for better mental health services for many years, this was deeply disappointing news.
For too long, mental health has been seen as the ‘Cinderella’ part of the health service. Somehow, because our mental health difficulties are not as visible as a broken leg or a stroke, they are seen as less urgent in the list of priorities.
But we know that’s not true. With more than 450 suicides last year and 11,000 presentations to A&E with self-harm, the losses we are incurring from mental health difficulties are intolerable. And these figures don’t show the thousands of people struggling to cope with mental distress on their own, or families who haven’t been able to get their loved one help.
Ring-fenced funding for mental health should not be viewed as a pot of money to prop up other areas of the health service. Decisions like this suggest that the mental health services are not as important as other parts of the health system. We still have a struggle on our hands to ensure mental health is taken seriously and given the priority it deserves.
This is the second time already this year that mental health funding has been unfairly targeted. While other areas of the health service received additional funds to deal with pressures of maintaining their services, mental health did not. And not only are the funds that were to be ring-fenced for new developments in mental health going to be diverted to other areas, but the remainder has not even been given yet to the HSE to start recruiting new staff – staff that are needed for vital areas such as mental health services for homeless people and maternal mental health care.
The diversion of funds does not recognise the huge ground that still needs to be made up in the mental health services in terms of staffing; e.g. we are still at only 75 per cent of required staffing recommended in the national mental health policy ‘A Vision for Change’, and we still have 1,000 fewer staff than there were in 2008 There is not the spare capacity within mental health services to take care of over-runs in other parts of the health service.
While we have received assurances that the €12 million will be returned to mental health next year, that is simply not good enough. There are lots of ways that this funding could be used this year. Why not upgrade the older acute wards around the country? Why not purchase facilities for the crisis houses that were promised in A Vision for Change? Why not use the funding to support mental health education in schools, or pilot advocacy services that could help families and people with mental health difficulties to get access to the supports they want?
Beyond the question of what happens to this €12 million, we need a step-change in the priority given to mental health. Much good work has been done to encourage people to seek help for their mental distress, and expectations are there that the services will be in place to respond.
We need full implementation of the suicide prevention strategy ‘Connecting for Life’. We need a national action plan to implement A Vision for Change. We need to bring mental health funding up to the best international standard. We need mental health law that protects people’s human rights when they are in mental health services and ensures they can make decisions about their own care. We need a ‘no wrong door’ policy across the mental health system, so that people with a dual diagnosis of addiction and mental health difficulty don’t get turned away, but get integrated support. We need advocacy services for people who don’t get the quality of care they deserve.
One area of mental health that has been largely ignored is maternal mental health.
Up to 20 per cent, or one in five, women in Ireland will suffer from depression during or after pregnancy.
About one in 10 new mothers will suffer from postnatal depression (PND); a debilitating condition which can develop at any stage in the 12 months post-delivery.
It is estimated that 50 per cent of all new mothers with PND might have been suffering from depression while pregnant that wasn’t identified, underlining the importance of early diagnosis and treatment. Yet Ireland’s mental health care for women in pregnancy and afterwards is pitifully under-developed. This was one of the areas that was due for development in 2016.
Mental Health Reform hears too many stories of people having difficulty getting support for mental distress. It’s time now that we said ‘enough is enough’.