The much anticipated Programme for Government has made significant commitments to the implementation of Ireland’s new national mental health policy, Sharing the Vision – a mental health policy for everyone, which is due to be launched Wednesday 17th June. Government strategies to reform our mental health system don’t come around too often. Our present (and soon to be replaced) national mental health policy, A Vision for Change, was launched in 2006, and before that was Planning for the Future, published in 1984. And yet, as we embark on another journey to reform Ireland’s mental health system, there is a sense of Déjà Vu that is difficult to ignore. Do our new mental health strategies always coincide with economic recession?
Launched in 2006, A Vision for Change received widespread support across the political spectrum and among people who use mental health services. Just a short time after publication, Ireland faced into significant economic trouble, a period of protracted recession and austerity. The negative effects of this time on people’s mental health are already well-evidenced. Following the economic crash in 2008 for example, a study by the National Suicide Research Foundation found that by 2012, Ireland’s male suicide rate was 57% higher than it would have been if the pre-recession trend had continued. Waiting lists for child and adolescent mental health services spiked in demand by up to 25%, leaving many families waiting, sometimes for over a year to get the help they needed. Our great plan to revolutionise our mental health system faced significant challenges – huge increases in demand, paired with limited staffing and budgetary resource. In some ways, our mental health system never recovered from that period. The HSE reported in 2018 that they needed €177 million to provide the full staffing set out in the national mental health policy, A Vision for Change.
Fast forward to 2020, Ireland once again is set to ring in a new mental health strategy on the brink of another potential economic recession. Today, though our mental health system has made huge strides forward, we still face many of the same challenges we did during the recession in 2008 – huge increases in demand for mental health services, not enough supply to meet that demand, and substantial under-resourcing. More significantly, we have not yet felt the impact of the huge burden the COVID-19 crisis is, and will continue place on people’s mental health, which is expected to be felt within the mental health services in the years ahead. We need quick and easy access to mental health services now more than ever. So, what do we do? How do we ensure our new mental health policy succeeds, and learns from mistakes of the past?
If we are to achieve real change there are many things we need to differently this time round. The commitments contained in the programme for government is a good starting point. Several of the shortfalls of A Vision for Change, such as the lack of a political accountability and implementation, have been addressed by the proposal to establish an implementation group for Sharing the Vision. However, a plan alone will not bring about the quality of services that people in Ireland deserve; the plan needs to be resourced. It is essential that Ireland’s mental health services have the capacity to cope with the additional strain they are now under as a result of the pandemic and will continue to be under into the future. Investing in mental health produces a bounty, not a burden – The World Health Organisation (WHO) reports that every US$1 invested in scaling up treatment for depression and anxiety leads to a return of US$4 in better health and ability to work; this can help our economy recover.
The pending publication of the new mental health policy reinvigorates the movement for a better mental health system for everyone. If these hopes and aspirations are to be sustained, we need real political leadership to drive forward this change. This should include a Super Junior Minister for Mental Health, with a seat at the cabinet table to make sure mental health has a voice.
Over the last 3 months, many, if not all, of our political leaders have spoken on the importance of mental health. We now need those words to become action. When the time comes to make difficult decisions, mental health must be prioritised. There is an opportunity for a new government to reflect on failures of the past and learn from these. We simply must not let history repeat itself.
Fiona Coyle, CEO, Mental Health Reform
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