‘Fit for Purpose Mental Health Service for All’ – CPsychI Pre Budget Submission 2019
The College proposes a list of priorities detailing a ‘Fit for Purpose Mental Health Service for All’ for psychiatrists and allied health professionals, patients and their families/carers.
Photo by Ibrahim Rifath on Unsplash
Recruitment and retention of mental health professionals is thwarted by services that are overall underfunded, pressured and restricted in its ability to support and treat service users/patients, making it unattractive as a place of professional satisfaction, growth and development. In its pre-budget submission the College calls for the budget to address Retention, Recruitment and Working Environment Issues for a workplace that attracts, trains and retains clinical staff from all necessary disciplines to our mental health services. Training and continuing professional education is very important in maintaining a high standard of care.
Currently there are 8 Consultant psychiatrists to every 100,000 of the Irish population. The College recommends an increase of 16 Consultants per 100,000. At present, many consultant posts across the country are vacant. As a result, patients do not get the expert service they require. Urgent plans are needed to address this situation and recruit qualified psychiatrists to consultant posts.
In the context of Psychiatry, the implementation of the MacCraith Report and the provision of attractive training and working conditions for both trainees and consultant psychiatrists need to be priortised (i.e. appropriately staffed teams and systems; protected educational time and resources for trainees and protected teaching/training time). The College Workforce Planning Report 2013 – 2023 provides an outline of the number of specialists and consultants that are required in Psychiatry in that period and addresses the policy documents and literature influencing these requirements.
An immediate increase of the mental health services budget is required. The mental health budget, which is circa 6% of the total health budget, remains scandalously low and inadequate for the increasingly diverse population with growing mental health issues.
The percentage of the health budget designated for mental health must increase to to minimum ‘Sláintecare’ recommended amount of 10% of the overall health budget, and increase to 12% at the very least by 2020. The College also recommends that 25% of the budget should be designated to Childhood and Adolescent Mental Health Services (CAMHS) to include maintenance and further development;
Begin with our children and adolescents to ensure future generations’ better health outcomes.
To run community-based recovery oriented mental health services, with a full shift away from a hospital-based system with acute and specialist services, as set out in A Vision for Change, adequate funding, resourcing and staffing are vital.
The reinstatement of a HSE Director for Mental Health is also necessary to lead and coordinate plans, ensuring the quality of services and equal access nationally to same. Implementation of a Mental Health information and communication technology (ICT) system with appropriate patient record access needs to be provided in each local service and across the health service to ensure co-ordinated, seamless services, patient safety and to provide national data to facilitate future service planning.
Increased re-admission figures and waiting list data indicate that people are not getting the community support they need. 24/7 multi-disciplinary community-based services for people with acute mental distress and those in recovery must be a priority. Primary care counselling with ease of access nationally must be sufficient to ensure ease of access through GP services for people in need will assist with its provision.
Budget actions (both taxation and spending) must support activities that reduce marginalisation and substance abuse, meaning calls for continued action on employment, housing and in support of community action groups that provide setting and activities that promote community activities and reduce isolation of individuals.