A Vision for Change nine years on

We are now in an economic recovery and it’s time to see that recovery in the provision of mental health services so that we can truly transform care for patients, writes Ms. Patricia Gilheaney, Chief Executive, The Mental Health Commission.

Ms. Patricia Gilheaney
Ms. Patricia Gilheaney

Nine years have passed since the Government published its mental health policy, A Vision for Change. The policy set out a ten year plan to shift the delivery of mental health services from the historical, old style institutional care to a more modern community based service. As we approach the ten year anniversary, and the culmination of the term of the policy, we can see that mental health services in Ireland have significantly changed, but there is a substantial amount left to do across the board, particularly in the areas of community services, staffing and the provision of mental health services to children.

The Commission’s 2014 annual report which was published last month highlighted that while mental health services regulatory compliance has risen steadily over the years, it has appeared to have plateaued and much work needs to be done to change culture and to refocus on the patient first approach to service delivery.

One of the key areas set out in A Vision for Change is that of service user and family supporter involvement. The way in which this is achieved is through individual care planning which puts the patient at the centre of their own recovery. Patients should to be listened to, and their views, opinions and needs should form an integral part of their care and recovery plan. Such a collaborative approach, between the patient and the service delivery team, is crucial and can often facilitate a quicker recovery. However compliance levels in terms of individual care plans is not what it should be and this is a priority area for the Commission.

Another key area of concern for the Commission is the staffing of community mental health teams. While this has improved somewhat over the past few years, there are still large gaps in teams, especially in relation to social workers, occupational therapists, nurses and psychologists.

Compliance levels in terms of individual care plans is not what it should be and this is a priority area for the Commission.

At the launch the Commission’s 2014 annual report we called on the Government to ensure that the necessary resources and supports were put in place to allow the full realisation of the first Mental Health Division Operation Plan for a recovery focused, clinically excellent service that provides for and fully involves service users and their families in all aspects of service delivery and development.

The Mental Health Commission has a role in inspection and regulation. It promotes, encourages and fosters high standards and good practices in the delivery of mental health services and it seeks to protect the interests of patients who are involuntarily admitted. We believe that if we as a society are to have a modern, fair, and integrated community based mental health service then every recommendation set out in A Vision for Change must be implemented in full.

The Commission is also of the view that as we approach the policy’s culmination it’s time to set a clear path on how mental health services should be delivered in years to come. It’s time to start planning the policy which will come after A Vision for Change and guide Ireland’s mental health care delivery for the next decade.