Dan Neville (Limerick West, Fine Gael)

I thank the Ceann Comhairle for selecting this item for discussion on the Adjournment.

On 24 January 2006, the expert group on mental health policy established by the Department of Health and Children published a new national mental health policy framework entitled, A Vision for Change. This was subsequently adopted by Government and the Health Service Executive. It proposed significant changes and improvements in mental health services and a true movement of services into the community. It made important recommendations on empowerment, advocacy, peer support, offering a range of therapies, supporting carers and, perhaps most important, recovery from mental illness.

I would like to quote from the Mental Health Commission's 2008 evaluation in this regard.

Regrettably, since the launch of A Vision for Change, there has been little action in its implementation. Two years later, mental health service users and providers are still struggling with an outdated, fragmented and severely under-resourced system. Mental health and related services remain amongst the most neglected areas of Government policy and provision, leading to multiple infringements of human rights of people with or at risk of mental health problems. There remains a widespread unavailability of psychological and social interventions as complements to medication, denying the right to the most appropriate and least restrictive or intrusive treatment. Ireland still has a high rate of hospitalisation for mental health problems, due to limited community-based services, conflicting with the right to treatment in the least restrictive environment. Specialist mental health services, such as services for people with eating disorders or brain injuries, remain generally unavailable outside of Dublin, while access within Dublin remains limited.

In her annual report of 2006, the Inspector of Mental Health Services found mental health provision to be ad hoc in nature, with serious deficiencies in community mental health teams around the country and no teams in mental health services for people with intellectual disability. Basic staffing is unavailable for children's mental health services throughout the country and, waiting lists for children's services remain lengthy. In 2006, 3,000 children and adolescents waited an average of 15 months for assessment and some families waited as long as four years in this regard. In 2007, waiting lists were even longer with 3,598 children waiting for assessment, one third of whom waited more than 12 months.

The reality within mental health services today is that A Vision for Change has not marked a turning point in Government attention to this neglect. While it is the stated aim of the HSE to move to a coherent, transparent and equitable resource allocation model, current funding for mental health services remains inadequate and inequitable. A Vision for Change is explicit that a minimum of an additional €25 million is required annually for a six year period to allow implementation of the mental health service expansion and improvement objectives.

I received several letters from the HSE in response to parliamentary questions requesting information regarding the €25 million allocation. I was informed on several occasions that €25 million had been allocated to this area in 2006 and 2007. However, on 9 January 2008, the HSE in response to a freedom of information request from the Mental Health Alliance stated that 57% of the developments funded in 2006 had been put in place at an annual cost of €17 million and 40% or €10 million of the funding provided in 2007 had been put in place. Of the €51 million we were told had been allocated, only €27 million was spent implementing changes. The HSE response stated that the balance of the funding from 2006 and 2007 had been time delayed to address core deficits in existing mental health services thus ensuring that the HSE met its obligations to deliver services within the Vote. This response makes it abundantly clear that almost half of the funding allocated for implementation of A Vision for Change has been spent in other areas.

Not one extra shilling has been provided in 2008 towards implementation of the recommendations contained in A Vision for Change. The funding has been cut and A Vision for Change has been abandoned by Government. The commitment to provide €25 million annually for a six year period was never met.

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