A short course in mental health for election candidates

a-short-course-in-mental-health-for-election-candidates

It’s not difficult to explain to candidates what the issues are in mental health. Anyone can start with the simple fact that Ireland’s mental health is worse than it needs to be.

The population of Ireland has some of the worst mental health in Europe:

  • Almost 10% of the Irish population over age 15 has a ‘probable mental health problem’ at any one time
  • Almost 20% of young people aged 19-24 years and 15% of children aged 11-13 have had a mental health disorder
  • Young Irish women are experiencing the highest levels of moderate to severe symptoms of depression across Europe.
  • Ireland has the second-highest suicide rate in Europe for young people aged 15-19

Meanwhile, thousands of people in Ireland who might need mental health treatment, such as talking therapy, are not getting it.

  • Referrals to child and adolescent mental health services (CAMHS) increased by over 40% from around 12,800 in 2011 to 18,100 in 2019
  • The waiting list for the first appointment with CAMHS has remained in or around 2,000 children since at least 2016
  • At the end of 2019, more than 8,000 people were waiting for a primary care psychology appointment, many of whom were children
  • Research shows that 78% of older people with depression and 85% of older people with anxiety did not report a doctor’s diagnosis, indicating large unmet mental health need among the older population in Ireland

The picture is bleak and deeply concerning. That’s why the general public think that mental health should be a political priority.

But it is possible for every election candidate to have a positive impact on this situation. The next step is to explain to each candidate that they can and should do something to improve Ireland’s mental health. What kind of commitments by election candidates would make a difference? Mental Health Reform’s 73 member organisations have put together the following three simple actions that they can support:

1) Invest in Irelands mental health services:

There are fewer staff in our mental health services today than there were before the recession in 2008, and in successive years, the proportion of the health budget going to meant health has actually gone down. Yet there is strong public support for investment in mental health services. The results of a national survey in 2018 showed that the public are willing to invest more in mental healthcare when compared to other healthcare programmes. Upwards of 84% of the public think that the health service places too little focus on mental health.

The request of candidates is simple: Ireland’s mental health budget must move from the current 6% to at least 10% of the overall health budget, with incremental improvement every year.

2) Make mental health services accessible 24/7:

Everybody knows that a mental health crisis can happen at any time, day or night, weekday or weekend. Mental health services need to be available for people when a crisis occurs. This means being able to respond 24 hours a day, 7 days a week. Yet many mental health services across Ireland are only open Monday to Friday, 9 AM to 5 PM.

Successive governments have committed to the roll-out of 7-day-per-week mental health services for adults, and while some progress has been made, many areas still do not have a 7-day-per-week mental health service for adults.

For children and adolescents, the situation is worse. Most counties in Ireland do not have 7–day-a-week crisis mental health service. Almost all Child and Adolescent Mental Health Services only open Monday to Friday, 9 AM to 5 PM. This means that if a child or young person encounters a mental health crisis in the evening or the weekend, one of the only options they or their parent has is to go to an Emergency Department (A&E) and wait, sometimes for 8-10 hours or more for help. Everybody knows that an Emergency Department is an inappropriate environment for a child in acute distress.

This needs to change.

Crisis mental health services need to be accessible to every community in Ireland, for people of all ages.

3) Update Irelands mental health law to protect peoples human rights:

Ireland’s current mental health law does not give adequate protection of people’s rights when they are in hospital for mental health treatment.

It has been almost five years since the Government committed to publishing the draft legislation to reform the Mental Health Act, and today, we are still waiting for it to be published. While we wait,

  • HSE community residences for people with mental health difficulties remain unregulated
  • Voluntary patients do not have basic rights to information and advocacy
  • Involuntary patients do not have the right to have their advance wishes about treatment respected
  • 16 and 17-year-olds have no legal right to consent to admission and/or mental health treatment, and
  • There is no independent review of the detention of people in hospital who lack the capacity to make their own decisions, and who are not covered by the current Mental Health Act

The Mental Health Commission has found that some service users feel coerced, disempowered and unsupported when being admitted to a psychiatric inpatient unit and that this had a long-term negative impact on their recovery. Furthermore, the regulator has said that there is a risk people in HSE mental health community residences may be experiencing abuse.

Ireland’s Mental Health Act, 2001 must be updated in 2020 so that people in hospital for mental healthcare have their rights adequately protected and they can feel safe accessing the mental health services they need.

That’s the recipe for better mental health in Ireland. It’s as simple as one, two, three. The people of Ireland care about mental health. It’s time for candidates to show that they are listening.

If you need to talk, contact:
Pieta House 1800 247 247 (suicide, self-harm; 24/7 support)
Samaritans 116 123
Aware 1800 80 48 48 (depression, anxiety)
Teen-Line Ireland 1800 833 634 (for ages 13 to 19)
Childline 1800 66 66 66 (for under 18s)
You can also text HELP to 51444 (standard message rates apply)

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Article by Dr. Shari McDaid
Dr. Shari McDaid was Chief Executive Officer of Mental Health Reform, the Irish national coalition advocating for reform of the mental health system, from 2013-2020. Leading this coalition of more than 70 Irish organisations, she advised successive Ministers of State for Mental Health, senior civil servants and HSE senior executives on solutions to improving mental health and related services. She has been a member of a number of ministerial-appointed committees, including the Healthy Ireland Council, the National Taskforce on Youth Mental Health, the Disability Stakeholders Group and the Oversight Group for the review of A Vision for Change. She has regularly appeared in broadcast and print media to both advocate for and explain mental health.
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