Wednesday, 13 March 2019
Ceisteanna Eile - Other Questions
Mental Health Services
A Vision for Change reached the end of its ten-year term in 2016 and preparations for a review and updating of policy have been under way since early 2016.
As a first step in this process, an expert evidence review was completed in February 2017. This provided both domestic and international evidence to determine the policy direction for a refresh of A Vision for Change.
In October 2017, the Department of Health established an oversight group to review A Vision for Change and to update the existing mental health policy having regard to the expert evidence review. This group is independently chaired by Mr. Hugh Kane.
The group focused on developing measurable outcomes within a patient-centred care framework. It engaged in a major national stakeholder process and collected additional information from stakeholder statements made to the Joint Committee on the Future of Mental Health Care. These national consultations concluded in August 2018.
Additional research was completed and relevant policies from other Departments were coded and incorporated into the refreshed A Vision for Change document.
The oversight group is in the process of editing chapters and it is anticipated that a final draft report will be finalised in the coming weeks. Once the final draft is received by the Department of Health, it will be reviewed and submitted to Government for consideration. There are several proposals recommending additional supports and these will be costed by officials in the Department. The views of other Departments will be taken into consideration prior to submission to Government. It is intended that this process will be completed in the coming months when the revised policy will be launched.
We await the review of A Vision for Change that will set out the future direction for our mental health services. A Vision for Change was a very important and progressive document that set out a pathway for providing mental health services. Probably 90% of it is still extremely relevant but it needs to be updated. I look forward to the review.
Obviously many aspects of A Vision for Change have been successfully delivered and in other areas it has under-delivered. In particular, child and adolescent mental health services and mental health services for people with intellectual disabilities are both significantly under-resourced. Will the review have full costings when it is published or will that be left to a future date?
I concur with the Deputy over the success of the first A Vision for Change document. It was probably one of the most ambitious documents launched in healthcare in modern times. Its success or otherwise can be debated, but it has transformed mental health care. It was an extraordinarily ambitious document published at a time when the country was awash with resources. The country entered into recession during that ten-year period and many challenges arose in implementing some of the ambitions. It may have been overly ambitious, but notwithstanding that it has had incredible achievements to its name over that ten-year period. If Sláintecare, which is also an ambitious ten-year plan, achieves half the success of A Vision for Change we can look forward to enormous successes in healthcare.
I recently met the oversight group for the new vision document. The group is concluding its work. I think it will be a very interesting and welcome document. The costings will not form part of that review; they will be considered by Government on an ongoing basis because some of them will be cross-departmental and cross-sectoral as we go along the way.
Is there a timeline for the costings following the review? It will be important to have costings set out so that the document is not purely aspirational. It will have more teeth if costings are provided. Will the review be a follow-on document? In other words will we be able to trace the steps from A Vision for Change into the review document, rather than being a total reset? It would be important to be able to continue to trace the successes and the absence of delivery in different areas in the current A Vision for Change document. Will the Sláintecare report be incorporated into this review?
The answer to the last two questions is "Yes". Sláintecare is very much in the background. This document is very much a progression from the first document.
The team that is putting it together has an eye to the first document. The members of that team realise that progress has to be made. It is not possible to do costings. Much of this document will be more outcome-orientated and less prescriptive. The last document was very prescriptive. It suggested that there should be a certain number of members on each team, that certain disciplines should be represented on each team and that there should be a certain number of teams. This document does not involve the same level of prescription. It focuses instead on what the outcomes should be. I do not think the costing of those outcomes can be done in a straightforward scientific manner. The best way to do that will have to emerge over time. This document is essentially looking at how we do what we do. It is ensuring best practice is involved all the times. Its predecessor was probably more prescriptive.