Dr. Fiona Keogh:

I have confidence in the document. I should declare a conflict of interest because I was a member of the oversight group that developed the policy. I was also the researcher working with the expert group that wrote much of A Vision for Change. I disagree somewhat with the Deputy on the implementation of A Vision for Change. Everything in it was not implemented and there is still a long way to go on staffing levels, but it brought about important changes in the mental health system and it set out the infrastructure we are now working towards. Implementation has been painfully slow, unfortunately.

The implementation structures in Sharing the Vision have been much more sophisticated from the outset, which was one of the difficulties with A Vision for Change. There is a very well-worked implementation group with a number of panels working to it. We have learned much more about how to go about implementation. In recent years, the mental health directorate in the HSE has adopted a very interesting approach to resourcing implementation. That was one of the points I made in my opening statement. We can sometimes think implementation is a magic process and if we really want to implement Sharing the Vision it will somehow happen, but we need to resource that process. It involves change and we all know that change, for structures and individuals, is difficult. We have to learn new things and change how we might have done things in the past. I have confidence the implementation structure is good. We need to support it with a critical eye and keep encouraging it, but also critically moving it forward.