We’re now a full nine years on from the moment Ireland got its much-needed roadmap to successfully dealing with mental health. The catalyst for a move towards a mature and active approach (still an ongoing process) was the publication of A Vision For Change, welcomed by all quarters at the time.
It was then that Mental Health Reform (MHR) was established to ensure that, rather than see goodwill and commitment fade, it instead flourished and gained momentum. MHR are there to address the issue of improving mental health services and be a voice for those finding it difficult to find their own. They’ve kept up their end of the bargain, and been vocal when others – namely the government – have dropped the ball.
This year, in the lead up to Budget 2016, they’ve been imploring people to head to mentalhealthreform.ie. and sign their petition to An Taoiseach and Ministers Varadkar, Lynch, Howlin, O’Sullivan, Burton, Kelly and Coffey.
Dr. Shari McDaid, the Director of MHR, both applauds the public response to date and emphasises that more signatures are still required to drive the point home.
“It’s really positive that people are more willing to say that they have had a mental health difficulty themselves and to seek help,” says McDaid. “That’s very positive, but we also need to know that there are a lot of competing issues that the government is up against. Traditionally, mental health was seen as the Cinderella service [neglected]. It was seen as an area where the general public was not necessarily that supportive of it as an issue. And so we really do need to keep making it visible to the government that people do want to see it as a priority. They want the government to prioritise improving mental health support.”
While McDaid is pleased with Minister of State Kathleen Lynch’s commitment to funding, following what Lynch herself admitted was a “serious battering” over government inaction in the area, there are separate issues that need addressing.
“Funding commitment is welcome,” agrees McDaid. “But the government needs to take urgent action to make sure that it is attractive enough to work in the mental health services. We have an issue at the moment – and the minister has acknowledged this – with difficulties in recruiting staff into the mental health services. That’s affecting all of the different disciplines and professionals, from nurses and therapists to psychologists and psychiatrists.”
Does she feel salary levels fail to reflect the important work they do?
“It is known that, at the moment, the salaries that are on offer for the mental health staff are not competitive with some other countries where people might want to work. Places like Canada, Australia, the UK. But it is not all about the salaries. Some of it is that people who are coming to invest their lives in mental health services as professionals want to know that they have a career path. They want to know that there are opportunities for their professional development, that they will get adequate training, and all of that needs to be put in place to make people feel that it is worth making the commitment to the Irish mental health services.”
Dr. McDaid singles out two high profile areas in which the government has been unable to deliver thus far.
“One is having adequate support out of office hours – 24/7 crisis support. The reality is that mental health issues don’t stick to office hours. They can arise evenings and weekends, and so it is really important that specialist help is available. They have not been able to deliver that across the country, though there are new systems coming into place.”
Even with that, follow-up treatment is crucial.
“Absolutely, and to have that kind of follow-up, what you need is a full multi-disciplinary input, including the support of people who have had experiences with mental health difficulties themselves and also the professional expertise. It is no good being discharged from hospital and then not hearing from anybody for a couple of months.”
The other area of similar concern is child and adolescent mental health services.
“We know there are still very high waiting lists for first appointments. We know that there is still about a third of children being admitted to adult wards, rather than making sure that all children are admitted to a psychiatric unit that is age appropriate. Those are just indicators really of the strain in the mental health system, and the challenge in terms of trying to provide a holistic, well-resourced and good quality service across the country.”
“Mental health issues can affect anyone,” McDaid concludes. “I have been through my own mental health challenges since I was a teenager. Being willing to ask for help, talking to professionals and talking to friends and people who have been through it, – all of that has helped to improve my own life with a mental health difficulty. I would encourage anyone to do that, but also at this moment in time, it’s really helpful to have people say: ‘we also do need investment in those public services so that they are available for people in crisis.’”