Mental health services ‘grossly under-resourced’
NO SPECIALIST TEAM IN EAST WICKLOW WHILE THE WEST HAS HALF NUMBER REQUIRED
A new report has criticised the under-resourcing of services for people with severe or long-term mental illnesses in County Wicklow.
Written by the Inspector of Mental Health Services, Dr Susan Finnerty, ‘Rehabilitation and Recovery in Irish Mental Health Services’ calls the continuing lack of development in mental health rehabilitation services across Ireland as ‘disappointing’.
The report highlights that there is no specialist rehabilitation and recovery team in East Wicklow and less than half the recommended number of teams in the west of the county. Nationwide, there are 23 rehabilitation teams – 48 per cent of what is required under current mental health policy.
Mental health rehabilitation services aim to improve the quality of life, social inclusion and autonomy of people with severe or long-term mental illnesses through appropriate support. The report compares the level of services currently available against the recommendations made in A Vision for Change, the Irish government’s mental health policy which was first published in 2006.
The report looked at the services provided by Community Healthcare East (CHE) which includes East Wicklow and in Community Healthcare Organisation 7 (CHO7) which includes west Wicklow. The report notes that both healthcare areas are a mix of urban and rural, which could make it more challenging to provide a consistent service.
While a consultant psychiatrist post has been approved for Wicklow, there have been difficulties filling the post. CHE has no specialist rehabilitation and recovery team even though four teams has been recommended by government policy.
The service for CHE is found to be ‘grossly under-resourced with one occupational therapist, one social worker and one clinical nurse specialist.’ There is also no assertive outreach team in CHE.
The report also highlights a lack of residential facilities in the area. It points out that there are no medium support residences in the area to help people achieve more independent living.
The efforts of staff are praised as ‘significant’ and ‘strong’ however, ‘the full provision of rehabilitation services is urgently required’.
In CHO7, the report notes that there are three rehabilitation teams. However, seven teams are recommended for the area under government policy. The area has less than half of the seven recommended consultant psychiatrists under government policy. Therapeutic staffing is also below the recommended level. Kildare-West Wicklow also has no assertive outreach team.
The report was generally positive about the involvment of local representatives on governance committees. It also praised the training offered to service users and carers. Collaboration between teams and staff training was also described as good. However, it concluded that the teams lack ‘enough resources to provide a comprehensive service.’
‘The long-term neglect of people with severe and enduring mental illness has negative outcomes for the service user and their families. Because of the unmet need for rehabilitation, many people with enduring mental illness have repeated admissions to inpatient psychiatric units, are then discharged, to be readmitted when things breakdown again – the so-called ‘revolving door’ of admissions,’ said Dr Finnerty.
‘In the long-term, this is counterproductive for both the service user and the already severely under-resourced acute services. The short-sightedness of not providing adequate mental health rehabilitation services, from both a human rights and a financial viewpoint, is quite astounding,’ Dr Finnerty added.