Dan Neville (Limerick West, Fine Gael)

This is my first opportunity to raise these issues as regards the development of the mental health services. Some people will say this will not be noticed but at least I take every opportunity I can to raise the matter.

The independent monitoring group report on the blueprint for improving the psychiatric service is a severe indictment of the Minister for Health and Children and the Government. It is not acceptable that little substantial progress was made in 2009 in the implementation of A Vision for Change. The lack of clarity around the new assistant director for mental health, the lack of authority around this post and the emerging clinical management and administrative structures within the health services is totally unacceptable. The monitoring group expressed frustration and confusion about constantly changing management structures. The assistant director for mental health that has been appointed, incidentally, is an excellent first-class public servant and this has nothing to do with either his ability or potential.

It is difficult for the newly appointed executive clinical directors to carry out their task when there is an absence of detail in their precise roles, the relationship with clinical directors and the management structure of the HSE. It is another damning indictment that the monitoring group found an absence of mental health leadership.

The revenue allocation envisaged in A Vision for Change was not delivered in 2009 as promised. In the absence of new capital and revenue resources, it is difficult to see how the HSE and the Government can achieve their objective to implement A Vision for Change.

There is a continuing drop in the expenditure on mental health. In 2009, expenditure was at 5.3% of total health care which reflects a continual decrease in the last number of years. The Government must immediately introduce an overall national strategy to ensure the service user and family involvement is an integral part in the mental health care service development.

The independent monitoring group report on the blueprint for improving the psychiatric service is a severe indictment of the Minister for Health and Children and the Government. I call on the Minister to account for this neglect and to honour the Government commitment to develop the mental health services.

There is a continuing drop in the expenditure on mental health. In 2009, expenditure was at 5.3% of total health care. It is extremely disappointing and unacceptable that little progress has been made in establishing fully developed and staffed community mental teams, both in adult and specialist mental health services. In the absence of developed resources and staff, it is difficult to see how a vision of a community based mental service can be implemented.

The Minister and the Government must immediately explain why there was a lack of significant progress during 2009 in the development of appropriate specialist mental health services such as rehabilitation, in recovery for older people, people with intellectual disability, forensic psychiatry, the homeless, co-morbid severe mental health, substance abuse problems and eating disorders. I met Ms Jacinta Hayes from Bodywise today to discuss the problems to do with eating disorders. There is also liaison, neuropsychiatry and borderline development disorder to be addressed. No progress has been made on those issues.

There was some progress as regards child and adolescent mental health services, but nonetheless these services have not received the priority and urgent attention they require. In the absence of any child and adolescent psychiatry anything would be seen as progress, but nonetheless I welcome whatever tentative steps have been made in this regard.

Ireland deserves a 21st century community-based person-centred mental health service grounded on the principles of recovery. People recover from mental illness. One in four will suffer a mental health problem at some stage of his or her life. Early intervention means complete cure while delayed intervention presents difficulties. Finally, the Government and the HSE must immediately renew their commitment to the full implementation of A Vision for Change.

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