While continuing to provide essential services to thousands of people around the country, it is widely acknowledged that Ireland’s mental health services are at breaking point.
Understaffing and a lack of resources mean the newly appointed Minister for Health, Leo Varadkar, has his work cut out in finding solutions to make the nation’s mental health services more accessible and, thus, more effective. According to some estimates, both staffing levels and the number of beds would need to increase by 33 per cent to come in line with the conditions set out in the 2006 Vision for Change reform plan.
Or will the days of “No room at the inn” simply continue?
Reform Begins by Listening
One element of our mental health services that seems particularly dysfunctional is the feedback loop from patients, which describes their experience of using the services they need. If these voices are not heard, it seems likely that any future reform would be one-sided at best, while the opinions of the actual ‘customers’ mental health services are there to serve would not be included in the reforms.
Recognising those seeking assistance for their mental health issues as essential stakeholders in any reform process, the group Mental Health Reform has sought to enable those using the services to file complaints if the standards of service experienced are not appropriate.
Mental Health Reform
A group of concerned individuals and organisations that recognise the need for a fundamental change in the way our mental health services do business, Mental Health Reform say that in their process of consultation with former patients and family members of persons with mental health issues, they have “heard the consistent message that people want to be listened to, to have a consistent supportive relationship with a professional and an offer of treatment that is not exclusively focused on medication.”
According to their website, “Mental Health Reform’s goal is an Ireland where people with mental health difficulties can recover their good health and live their lives to the fullest.” The body seeks to bring about both structural and cultural changes in Ireland’s mental health matters.
Feedback from Patients and Carers
One interesting aspect of their sourcing of information is the direct and honest appraisals made to Mental Health Reform by patients in the system and parents or guardians of such patients.
The interviews detail a certain lack of humanity and compassion at the core of the mental health services, which were found to be “dehumanising” and a grave injury to many of those who are truly in their hour of need.
Affected parties were allowed to make full and frank anonymous statements to Mental Health Reform, which were variously framed as “Anne’s story”, or “Christina’s story”, and tell of the malaise at the heart of our services with alarming clarity.
“Everything was too rushed and so cold and clinical that I just wanted to run…” says Christina (not her real name), recounting her suffering with depression and her challenge in overcoming suicidal thoughts while seeking the assistance of the mental health services. “I felt really alone in the whole situation…I had arrived a bit late and the woman at reception was just horrible to me. You'd think the people who work in those places would be trained and employed on the basis of having some warmth or something…”
Redress
One major challenge faced by patients and carers who do not receive services of a reasonable quality is their lack of knowledge on how to file a complaint, or who to complain to. Some stakeholders have stated that the mental health services seem to have adopted a culture of intransigence—and that if one complains, nothing will be done about it anyway.
It would seem that, if large numbers of patients and carers are significantly disappointed with the service they receive, that this should be taken seriously and a formal complaints procedure be introduced. Perhaps in this way can the voice of the patient be heard.
When some 261 patients died in 2013 while in the care of the mental health services (including 23 “unexplained” deaths—normally attributable to suicide), it would seem that something is not quite right in our mental health facilities.
