Ireland | Niamh Wrenne
It has become a well-known fact that as a nation, we struggle significantly with our mental health. 392 people took their own lives in this country last year. In 2017 alone, the National-Self Harm Registry Ireland recorded 11,600 hospitalisations due to self-harm. There is clearly an ongoing Irish mental health crisis, and yet this has not been reflected in our government’s actions over the years.
In 2006, the HSE released a strategy document setting out the direction for mental health services in Ireland. ‘Vision for Change’ recommended that the national budget for mental health should be at least 10%, while the budget of countries similar to Ireland is around 12%. However, in the twelve years since that recommendation was made, the budget had remained at 6%. Why has it continued to stay at an unacceptably low level?
The State’s lack of action is a clear indicator of how the members of our government, past and present, pay little heed to the mental health of our nation. Of course, this may be due to the fact that in the past, mental health in general (let alone mental illness) has been a ‘taboo’ topic in Irish society. Politicians have either turned a blind eye to the problem or have not considered it important enough to address in a serious way. Therefore, for many years Irish mental health services have not received the necessary level of funding. There is a severe lack of nationwide services, and where there are services available, they are understaffed and have shamefully long waiting lists. If our government does not begin to invest and back major change, the level of care provided to vulnerable individuals will continue to be unsafe and insufficient.
Time and time again the State has tried and failed to reform the mental health service. For example, it appears that the State has failed to properly resource and implement its Child and Adolescent Mental Service. This is a vital service to many that provides assessment and treatment for young people and their families who are experiencing mental health difficulties. In many cases it is the only option for young people who cannot afford private therapeutic care, which can cost €50 - €65 and upwards per session. In March of this year it was reported that there were nearly 2,700 children and young adults waiting on an appointment. Just under 400 of these children had been waiting over 12 months. This is a shameful treatment of some of the most vulnerable members of our society.
Similarly, the Mental Health Commission, in its annual report, found that the number of children placed in adult mental health units rose by 20% in spite of repeated criticisms of this practice. Earlier this month, director of Mental Health Reform (Ireland’s leading national coalition on mental health) Dr Shari McDaid called for the Government to seriously increase its investment in mental health. She said that even with investments of over €200 million between 2012 and 2018, the current Irish mental health services are still unable to cope with the amount of people seeking access to much needed supports.
Ireland has even been criticised internationally for its lack of reform in mental health services. A report earlier this year found that austerity measures that have been imposed since the crash, as well as a lack of clear policy guidance has impacted progress. The ‘Mapping and Understanding Exclusion in Europe’ report also commented that staff shortages and lack of funding impose difficulties on already existing services. The extent of this crisis is glaringly obvious – the report noted that long-stay ‘community residences’ designed for up to 25 people per unit actually accommodate close to 1,500 individuals. 90% of Irish mental health difficulties are dealt with in the primary healthcare system. It was reported that “the lack of specialist knowledge and long waiting times are making this level of healthcare often unsatisfactory for users”.
It’s obvious that things have needed to change for several years, and on Tuesday the 9th October our government proved once again that mental health services take a back seat in its eyes. In Budget 2019, Finance Minister Paschal Donohue allocated an extra €84 million for mental health services. The total available funding for mental health in 2019 is €1 billion – remaining at 6% of the overall health budget of €17 billion. The recommendations put forward by the Mental Health Reform coalition, who proposed additional funding of €105 million in 2019 for primary, secondary and tertiary mental health services, were completely ignored. It is a frustrating truth that the Irish government apparently do not consider a comprehensive mental health service a priority in our overall healthcare system.
The Irish mental health service is crumbling. There are simply not enough resources, staff, medical professionals or money to provide the level or care that is required. What we need is a robust and stable system that can care for those who are in desperate need of it. In recent years Irish society has made leaps and bounds in its attitudes towards mental health and mental illness – campaigns and charities such as A Lust for Life have opened up conversations surrounding mental health, without fear of stigma. It’s time that the Irish government reflects the changing attitudes in our society and start making real, tangible investments in our mental health services.
Originally published 22.11.18 in Vol. 2 No. 1.