Protection of the vulnerable continues to be a Government priority, especially in these challenging times, and those with mental health issues are often among the most vulnerable in society.
Access to services is central to the Government’s commitments under Sláintecare and the new national mental health policy, Sharing the Vision, and the Programme for Government: Our Shared Future highlights these policies. The Government’s commitment to continued enhancement of mental health services is shown in ongoing increases in the mental health budget. Since 2012, €315 million has been added, bringing the mental health budget today to €1.026 billion, an increase of 44%.
Much has been achieved in mental health in recent years, but it is recognised that much remains to be done. Ireland is fortunate to have fundamentally robust legislation, policies and services that have been built up over time and which, overall, compare favourably internationally. More importantly, there are identified and widely agreed pathways to undertake further improvements in all these areas, including improved residential and community-based care for children and adults and psychiatry of later life.
Sharing the Vision promotes equitable access to quality, safe mental health care for all citizens. Service users and their families, carers and supporters will have timely access to evidence-informed mental health services. Tailored measures will be put in place to ensure that individuals with complex mental health difficulties can avail of services across the State without discrimination. This builds on the intent of A Vision for Change and Sláintecare and is expected to be implemented as part of a ten-year plan.
Sharing the Vision recognises and plans for the increasing need for mental health services and demand for more holistic person-centred responses. The ten-year plan addresses population needs through a focus on the requirements of individuals. It promises early intervention, with a focus on prevention and positive mental health promotion. This focus advocates a mental health system that works in partnership with service users and their families to deliver a range of integrated services and supports.
Establishment of the National Monitoring and Implementation Committee (NIMC), to oversee Sharing the Vision, is well advanced. The NIMC will drive reconfiguration, monitor progress against outcomes and deliver on commitments in the new policy.
This year has been exceptional. The Covid-19 pandemic has caused significant stress, anxiety, worry and fear for many people throughout the world, from the disease itself and from impacts such as increased social isolation, disruption to daily life and uncertainty about employment and financial security.
The HSE has continued to provide all community services, as far as possible, while following Covid-19 guidelines to ensure protection for patients and staff. Acute inpatient and community residential facilities have remained open and patients have been provided with services throughout the pandemic, although with reduced numbers in some settings.
Covid-19 has rapidly accelerated online delivery of mental health services. The Department of Health, with the HSE, has launched a number of initiatives to promote mental health and well-being, including the national Crisis Text-Line in June. An additional €2.2m has been provided for a mental health promotion and well-being campaign, through enhanced online supports and to support the HSE psycho-social strategy. This will enable implementation of integrated tele-health solutions and improve existing online interventions. Examples are the free counselling sessions offered by HSE partners MyMind and online peer support groups for front line workers from Turn2me.
A key priority for Minister Butler and the Department is to update the 2001 Mental Health Act. The Act sets out the care and treatment of people (including children) with mental illness, including involuntary detention procedures and patient safeguards. The updating process is in line with expert advice, international best practice and human rights. The Department is finalising draft heads of a bill to amend the Act and hopes to finalise a draft bill by the end of 2020.
Another priority is the new forensic mental health facility at Portrane. This significant and modern facility is expected to open early next year. The new 170-bed hospital complex will replace the Central Mental Hospital Dundrum (103 beds) as a modernised National Forensic Mental Health Service. It will include a 120-bed central mental hospital, a 10-bed forensic child and adolescent unit and a 30-bed intensive care rehabilitation unit.
Funding will be sought in this year’s Estimates campaign to implement the short-term objectives of Sharing the Vision. This will, of course, be influenced by the availability of resources. However, the current budget of over €1 billion enables the HSE to maintain and develop its wide range of mental health and suicide prevention services. These span all specialties and ages, from mental health promotion and early intervention to acute inpatient care and clinical programmes such as self-harm and eating disorders. Improving access and reducing waiting lists, where possible, are key Government objectives, despite acknowledged recruitment difficulties and the greatly changed Covid-19 operational environment.