THERE IS a gloomily familiar ring to the findings of the fifth report of the Inspector of Mental Health Services. It found that hundreds of people continue to languish in inappropriate Victorian institutions. Children are being routinely admitted or detained in adult psychiatric units without proper care. Community-based services are in danger of becoming mini-institutions due to lack of access to multi-disciplinary care. These are the realities of an outdated, fragmented and under-resourced system where there is no end in sight to decades of institutional neglect.
On one level, this should cause no surprise. Health services have always treated mentally ill people in an appalling manner and mental health services have consistently been the most neglected quarter of the health sector. But what makes these findings shocking is that they come more than three years after Vision for Change was adopted as Government policy, accompanied by pledges that it would be fully implemented.
When this strategy was published, many dared to believe a turning point had been reached. For the first time, it seemed, there was a plan to transform psychiatric services with unprecedented resources at the disposal of the Government and, most importantly, apparent political will to implement the changes. Much of that optimism has faded now. Promises over funding have been broken, there is still no detailed implementation plan and there have been no real improvements for the many individuals who access mental health services.
But it is vital that these plans are not allowed to slip away if there is to be an end to this persistent neglect. It is more important than ever that authorities hold fast to their commitment to ring-fence money from the sale of old psychiatric institutions and invest it in a modern mental health service.
Management needs to change too. The Government and the Health Service Executive must accept that a separate directorate for mental health is vital if the sector is to emerge from the shadow of more mainstream health services. Consultants and clinicians, too, must face up to the fact that patients have rights and deserve a service which meets their basic needs.
The economic downturn is no excuse for inaction. Many reforms require leadership rather than resources, while changing attitudes towards people with mental health problems will not involve any economic burden. Change cannot come quickly enough for those entitled to a humane and responsive mental health service.
