Dr. Shari McDaid:

I thank the Chairman and the committee for inviting Mental Health Reform to appear before it. Mental Health Reform is a national coalition of 39 non-governmental organisations promoting improved mental health services and implementation of the Government’s mental health policy, A Vision for Change. I wish to share some of the concerns expressed to us in public meetings this year.

Shortfalls in staffing still have a negative impact on people seeking support. One person was on a list to see a psychologist but lost access because the psychologist went on maternity leave and was not replaced. Another person told us that because there are not enough professionals to provide support, people on a waiting list are seen by a student trainee. We also know that waiting times for child and adolescent mental health services had increased at the end of 2012 and were 17% higher than in 2011. At our public meetings, people told us of their difficulty accessing services when they are in a crisis, resulting in long waits in accident and emergency units, which are inappropriate and stressful places for someone in mental and emotional distress.

As committee members know, central to the Vision for Change policy is the development of holistic, multidisciplinary, community-based services. We welcomed the commitment in the previous two budgets to invest €35 million in community mental health services, including a commitment to appoint 891 staff in total between 2012 and 2013. However, there continues to be a challenge in translating this commitment into reality. The Minister, Deputy Reilly, reported in a Topical Issues debate on 19 September that a total of 803 of these posts were at some stage in the recruitment process, with almost 400 of last year’s posts either filled or awaiting clearance and 220 of this year’s posts having been accepted. However, the HSE's staffing report for the end of July showed a net increase of just 192 posts, which represents an increase of approximately 2% in staffing. We are concerned the pressure on the HSE to lose 2,400 whole-time equivalents throughout the health service is undermining efforts to resource mental health services as the Government intended. Our recommendation to the Government ahead of the budget for 2014 is that the €35 million be allocated for community mental health services as promised in the programme for Government.

This year, as we did last year, we highlight the need for a national information system for mental health services. Under HSE structures, it is not possible to tell how many mental health service users await psychological therapies, how many have an individual care and recovery plan, how many service users are satisfied with the service or how many are using community-based services. We call for an allocation towards this in 2014 and that the Department of Health ensures the new director for mental health, Mr. Stephen Mulvany, makes real progress in 2014.

Mental Health Reform recognises the Government faces difficult choices in this year's budget to maintain control over the country’s finances. The recommendations we make in our pre-budget submission are based on cost-effective solutions which would help Government services for people with a mental health condition be more efficient and, at the same time, fulfil the Government’s policy commitments on mental health.