Delayed delivery on mental health

Brian Howard, CEO for Mental Health Ireland

BY ELLA O’DWYER

ONE IN TEN people in Ireland are reckoned to suffer from mental health problems. Physical and mental health are two sides of the same coin but when it comes to mental health services the issue is more complex. While a person suffering from a physical ailment will have no problem letting it be known, the person with a psychological problem may be very much more reluctant to say so. A stigma still hangs over the whole mental health issue and that taboo further constrains and isolates the sufferer. While a commitment to progressive change has been made at Government level, there has been a long delay in delivery.
People in the sector, practitioners and patients, are pushing for the implementation of the Government’s mental health policy document A Vision for Change. This progressive policy document was published four years ago but its recommendations still haven’t been acted upon. Individuals affected and organisations working in the field (like Mental Health Ireland, Aware and Headstrong) have cross-party support in their attempt to have the report’s recommendations put into effect and Amnesty International Ireland has thrown its weight behind them.
Colm O’Gorman, Executive Director of Amnesty, says the hope generated by the publication of A Vision for Change in January 2006 is fast fading and mental health is under-prioritised.
“The Government,” O’Gorman says, “has not brought about the changes necessary to deliver a modern mental health service. This has happened in part because mental health is not given the priority it deserves. We urgently need a renewed political commitment to mental health from all parties.”
Brian Howard, CEO for Mental Health Ireland, welcomes the cross-party participation in the promotion of the policy document but again is concerned about the delay.
“The Government document is about a vision for change,” he says “but that policy document is four years on the go now. It received broad approval, including from our own organisation. It was a very progressive document but, like all documents, the proof of the pudding is in putting it into implementation.
“Although there have been some moves in the last four years, it’s the pace of implementation that is worrying. All we require is that the mental health sector is treated equitably compared with other services in the sector but we’re behind.”
This has been an ongoing trend, Howard says.
“Traditionally, mental health services have never been up there like the cardiac or cancer services and general health services. The mental health sector has been left behind. The organisations representing sufferers have voiced their concerns year on year and now with the economic difficulties these services are even more needed given the inevitable stress and anxiety that goes with financial problems. But even in the relatively good times mental health services were considered minority services, despite the fact that it’s accepted that one in every ten of the population suffers from mental health difficulty. If you translate that into real numbers that’s over 400,000 people - that’s the size of the problem. And, of course, there’s the worrying rise in suicide rates, especially among young men.”
Then there’s the stigma factor.
“There has been a lot of stigma around mental health for so long that invariably the problem was hidden. You only have to go back a few decades ago when the sufferer would end up in big institutions, behind high walls. That is no longer the case, thankfully, but unfortunately there’s a sort of hangover from that kind of mental health service. If someone has a physical ailment there’s never a reluctance to talk about it but when it comes to mental health problems there is still a reluctance on the person’s part to talk about it.
“Our organisation strives to promote the voices of people who use the services. Again, for many years regrettably, the voices of those who used the services weren’t heard. Their voices are increasingly more vocal and to the fore in relation to what precisely is needed.”
The launch of ‘Second Opinions’, a summary report of the National Services Users’ Executive (NSUE) Survey of Members on Vision for Change policy, took place last Monday. I put it to Brian Howard that amongst the findings of the survey conducted was that two in five of those surveyed were unhappy with the services available to them.
“That is no great surprise to me”, Brian says. “Five hundred people reported back in the survey on what they thought of the services available for mental health suffers and there’s a sizeable proportion of people who were not happy with the services. But we all have to work together to improve things, recognise where there have been deficiencies and work together to try and improve the lives of sufferers.”
Areas for potential improvement were identified through the NSUE survey, for instance, in relation to the range of treatments, with many people feeling there was excessive use of medication, as opposed to alternative treatments. People felt they needed to be listened to more and treated as equals. Sinn Féin’s ‘Health in an Ireland of Equals’ policy document speaks very much to the results of the findings of the sufferers questioned in the NSUE survey.
Sinn Féin’s health policy proposes the introduction of legislation “to introduce statutory rights to equality and self-determination for people with mental health needs, to ensure empowerment of people with mental health needs, to guarantee a right to participation in decisions affecting them”.
Sinn Féin spokesperson on Health and Children Caoimhghín Ó Caoláin fully supports the push to have A Vision for Change implemented and quickly.
“Sinn Féin is fully behind the drive for the full implementation of the policy document,” Ó Caoláin says.
“It’s fine having these aspirations in the report but it’s the implementation that’s essential and Sinn Féin supports every move to have the implementation time brought forward.”
The issue of the implementation of the policy document is to go before the Oireachtas this week. Hopefully, some movement will take place but that remains to be seen.

Colm O’Gorman, Executive Director of Amnesty and Sinn Féin spokesperson on Health and Children Caoimhghín Ó Caoláin