Political snakes and ladders approach to mental health must end

Once again we find ourselves in a place where due to a change of leadership in our governing party Fine Gael, there is the inevitable yet totally destabilising cabinet reshuffle. The demotions and promotions made for some interesting reading and was a rare window into the cut throat nature of usually tinted window politics.

One appointment was the elevation of Minister Helen McEntee, a politician who rigorously backed Leo Varadkar from day one in the leadership race, to Minister for European Affairs which no doubt is a positive trajectory for her career. Minister McEntee whose previous role as Minister of State for Mental Health and Older People, although a junior ministerial role, was a hugely important position and no doubt one that she had an unquestionable passion for.

Having worked with Minister McEntee in the past it was clear she was only developing her relationships with the relevant parties, individuals and organisations. It would take anyone time to get a full depth of understanding necessary into how it all works, who’s who and what the best route forward is. Minister McEntee no doubt submerged herself into the bleak reality of how truly broken our mental health system is and the work that needs to be done to bring it even close to where it needs to be, a difficult job for anyone.

Yet, just as she established a hopeful momentum in a handful of areas, she is removed from her office. Whether or not this was a move Minister McEntee may have wanted or not, this role is now passed onto to another politician Minister Jim Daly to commence forging those relationships and connections all over again from scratch, and to get an understanding of the full depth and breadth of the mental health system, from scratch. Akin to a game of pass the parcel, other than the fact we are playing with people’s lives here. Minister Daly may well be a man that can drive progressive change and this is in no way questioning his capacity to do so but this roll over substitution approach is hamstringing the already immensely slow process being made when it comes to mental health in Ireland.

I think the question also has to be fairly asked of our outgoing Minister McEntee and also our Minister for Health Simon Harris, in terms of genuine achievements in this short period of time, what is it they believe the government have made progress on when it comes to mental health? And how far away are we still from making community mental health care available 24/7?

It’s important here to decipher the difference between progress in planning, research, writing up documents and dialogue, and progress in genuine action and implementation of policies. We have had many well intentioned plans and policies in the past, that continue to gather dust on shelves such as A Vision for Change (a highly progressive document created 10 years ago), having delivered little meaningful external action to impact people’s lives on a mass scale. It seems to be one broken promise after the other with nobody staying around long enough to ever be held accountable. We also have to ask the question, respectfully, how much power does a junior mental health minster have to instigate real political and systematic change?

Anyone with even an ounce of comprehension on leadership and organisational structures can see that this is a snakes and ladders model, and it doesn’t work. The external lack of social impact illustrates this. Policy change and implementation of policy into real life needs to move beyond the arena of political desire for power and electioneering. It’s failing time and time again and it is the people that suffer, due to the severe lack of long term vision and lack of across the board party agreements on what policies need urgent action.

Accountability from those in power for lack of implementation is a must. Who is responsible for the lack of full implementation of A Vision for Change for example, and why are they not being held accountable? We simply must hold our public servants accountable to policy implementation.

This is the reality of what we are dealing with now in Ireland… Closure of adolescent psychiatric beds leaving many teenagers in adult psychiatric wards, the horror stories from accident and emergency departments up and down the country where distressed and vulnerable men, women and children are being turned away, the ongoing dual diagnosis debate where those with addictions and mental health issues can’t be treated for both at the same time, our outdated and insensitive mental health acts, some of the highest suicide rates among teenagers in Europe, the over reliance on a decimated and barely functioning reactive model rather than a systematic educational preventative model approach, ad campaigns urging people to talk yet when they do they sometimes find themselves sitting on waiting lists for up to two years and then enter a system where they could have a different therapist each week, re-hashing their story to a stranger time and time again… too many stories, too much suffering. There are some phenomenal people working in the healthcare and indeed the political system who know exactly what needs to be done to fix these issues, it just isn’t happening. Why is this?

I also have met many incredible people that work within our health and education systems and they, on a daily basis, are putting their own self-care in danger in many ways due to the lack of resource and supports they receive. I feel in order for them to do their job safely and to the best of their ability a gargantuan change must occur. Minister for Health Simon Harris to be fair has been on recruitment drives constantly, but show me a clinical psychologist or nurse that would enter a system that often has to tell suicidal teenagers and adults that they can’t be seen for over a year. I know I wouldn’t be able to do that. This is something I have heard time and time again all throughout Ireland. It’s not money that will bring these professionals home, it’s a system that they believe in, know is sustainable and actually works.

We now have 19 junior minsters all being paid handsomely by the tax payer. I feel it’s about time we see a senior position for a Minster for Mental Health in Ireland due to an ever increasing epidemic of mental health challenges we are collectively facing. This Minister needs more power and control to exert authority and do what needs to be done, along with a real desire for progressive urgent action along with a team who deeply understands all spokes of the wheel and how it revolves and can evolve.

However, having witnessed the slow reactions of our powers that be towards the emotional, wellbeing and mental health of our country I have a feeling it’s the rising up of the people and their voices that will in the end be the real catalyst to drive this much needed change. Whenever the next election occurs I feel those passionate about this area have a responsibility to magnify their voices and sculpt a movement that demands action from our politicians, whose wages and pensions are paid for by the public. It’s also not just up to the government alone to drive change. We all have our part to play here.