Reform of mental health services must be an election issue

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2011ELECTIONMANIFESTOSUMMARY

Improving mental healthservices is an essential part ofpolitical and social reform in

Ireland. The quality of mentalhealth services has a majorimpact on us all – one in fourpeople experience a mentalhealth difficulty during theirlives.

A Vision for ChangeWe need to move tocomprehensive community basedservices, as set out in Ireland’smental health services reform planA Vision for Change.

Since launched in 2006,implementation of A Vision forChange has been slow leavingmental health to continue as the‘Cinderella’ of the health services.At the current rate of progress itwill not be implemented - even bythe outside target of 2016.

FIVE KEY REFORMS

1. Establish an AccountableStructureEstablish a dedicated executiveposition at the highest level of theHSE that is responsible forimplementing A Vision for Change.This should be led by a Directorfor Mental Health Services whohas executive powers, animplementation budget andresponsibility to report publicly onprogress.

2. Publish a PlanPublish a comprehensiveimplementation plan for A Visionfor Change setting outdeliverables, a timeline and who isresponsible.

3. Financial CommitmentCommit to raising funding ofmental health services from 5% to8% of the health budget by 2016

and to clear reporting on mentalhealth spending.

4. Enact LegislationEnact legislation to improve thehealth service’s accountability for planning and financing mentalhealth service reform.

5. Promote Cross-departmentalActionPromote specific cross-departmental action on mentalhealth and the implementation ofthe National Disability Strategy toeffectively combat social exclusion,prejudice and discriminationagainst people with mental healthproblems.

Mental Health Reform

Mental Health Reform wasestablished in 2006 (then calledthe Irish Mental Health Coalition)as a coalition of organisationscampaigning for improved mentalhealth services. It is committed toplacing mental health in a centralposition within the public discoursefor reform.

Make mental health reform a priorityImproving mental health services is an essential part of political and social reform in Ireland. Thequality of mental health services has a major impact on us all – one in four people experience amental health difficulty during their lives.

More information W: www.mentalhealthreform.ie E: [email protected] T: (01) 822 7752

http://www.mentalhealthreform.ie/



mailto:[email protected]





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A Vision for Change

We need to move tocomprehensive communitybased services, as set out inIreland’s mental health servicesreform plan A Vision for Change .

Since launched in 2006,implementation of A Vision for Change has been slow leavingmental health to continue as the‘Cinderella’ of the healthservices. At current rates ofprogress it will not beimplemented - even by theoutside target of 2016.

FIVE KEY REFORMS

1. Establish a Structure

The ProblemA Vision for Change has nosingle senior executive withinthe HSE who is responsible forexecution. As a resultresponsibility falls between thecracks and no-one can be heldaccountable for ongoing slowprogress.

The SolutionEstablish a dedicated seniorexecutive position within theHSE which is responsible forimplementing A Vision forChange. This should be led by aDirector for Mental HealthServices who has executivepowers, an implementationbudget and responsibility topublicly report on progress.

Make mental health reform a priority

• Improving mental health services is an essential part of politicaland social reform in Ireland.

• The quality of mental health services has a major impact on usall – one in four people experience a mental health difficultyduring their lives.

• Community Mental Health services, the cornerstone of a modern

mental health services, are poorly resourced in favour ofexpensive inpatient facilities - including old institutions unfit forpurpose.

• Demand on mental health services increases at time ofeconomic and social recession – as evidenced by the growingnumber of suicides which increased by 25% in 2009.

• Mental health funding is at its lowest level in modern history at just 5% of the HSE budget.










2. Publish a Plan

The ProblemA Vision for Change has nocomprehensive implementationplan, meaning it is impossible tomeasure and scrutiniseprogress.

The SolutionPublish a detailedimplementation plan setting outdeliverables, a timeline and whois responsible.

3. Financial Commitment

The Problem Mental health services in Irelandare underfunded. Mental healthreceived approximately 5% ofthe health budget in 2010having dropped from 13% in1986. This comparesunfavourably with 12% inEngland and 18% in Scotland.

There is a lack of transparencyas mental health funding isadministered from within theoverall HSE budget.

Progress on closinginappropriate Victorian mentalinstitutions in particular has

been slow. In many cases thishas been delayed by a lack ofresources to develop thecommunity based mental healthteams.

Mental health services haveexperienced a disproportionateloss of staff as a result of thepublic sector staff moratorium.20% of posts lost in the HSE in2010 were from mental healthservices even though the care

group represents just 9% of theworkforce.

The Solution

Bring the proportion of fundingon mental health services to 8%of the health budget by 2016, asset out in A Vision for Change.

Ensure clear reporting onmental health spending.

Fastrack funding to provideimproved community basedservices. When old institutionsare closed lands can be soldreclaiming money for thetaxpayer.

Recruit additional staff to workin community based mentalhealth teams to bring thereduction in staff numbers inmental health services into linewith that experienced in otherareas of the health service.

4. Enact Legislation

The ProblemThere is no legal framework torequire the health service toimplement A Vision for Change.

There is out-of-date legislationto protect people who lackcapacity, because of a mentalhealth difficulty, to be able to

make decisions for themselves.

Mental health is not sufficientlyrecognised and included withinthe targets of the NationalDisability Strategy.

The SolutionEnact legislation that placesobligations on the HSE to plan,deliver and report on A Visionfor Change and that provides forinspection of community-based

mental health services.


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Enact comprehensive capacitylegislation that complies with theUN Convention on the Rights ofPersons with Disabilities.

Ensure that mental health ispromoted and acknowledged asan integral part of delivering theNational Disability Strategy.

5. Promote Cross -departmentalAction

The Problem Many people with mental healthdifficulties face discrimination inmany areas of their life – securing jobs, getting housingand socialising.

People with a mental health

disability participate in the Irishlabour force at less than half therate of the general population.

Few specific measures havebeen taken on mental healthwithin the National Disability

Strategy, or in other socialinclusion programmes.

The Solution Promote specific cross-departmental action on mentalhealth. Departments coveringsocial welfare, education,employment and housing

should set out how they willimplement A Vision for Change.

Commit to implementing theNational Disability Strategy toeffectively combat socialexclusion, prejudice anddiscrimination against peoplewith mental health problemsand support the structuresrequired to monitor and drivethe Strategy under the directionof the Department of An

Taoiseach.

Ensure that specific measuresare taken to improve access toemployment and housing forpeople with a mental healthproblem.


Mental Health Reform

Mental Health Reform was established in 2006 (then called the IrishMental Health Coalition) as a coalition of the founding organisations whichinclude Amnesty International Ireland, Bodywhys – The Eating DisordersAssociation, Grow, the Irish Advocacy Network and Shine. Mental HealthReform is currently expanding its membership and is committed to placingmental health in a central position within the public discourse for reform.

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Reform of mental health services must be an election issue