Prioritising Mental Health

PRIORITISING MENTAL HEALTHCARE #better4health www.sinnfein.ie/better4health

A Sinn FĂŠin Policy Document February 2016

Prioritising Mental Healthcare

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INTRODUCTION Sinn Féin seeks to build in Ireland a truly fair society based firmly on equality - a New Republic that brings to fruition the ideals and aspirations proclaimed 100 years ago at Easter 1916.

As a party committed to equal rights and equal opportunities as guaranteed in the 1916 Proclamation and to cherishing all the children of the nation equally, Sinn Féin is duty bound to bring forward policies and programmes that will make those principles a reality in the lives of the people.

In this document we present our policy priorities to achieve a resourced mental health sector that provides an adequate level of service to the many thousands of patients in receipt and in need of mental healthcare.

As Irish Republicans, our aspiration to make healthcare a national priority is also in the tradition of the Democratic Programme of the First Dáil Éireann which states that “it shall be the duty of the Republic to take such measures as will safeguard the health of the people”. And we look to inspirational figures such as Dr. Kathleen Lynn, 1916 veteran and founder of St. Ultan’s Hospital for the children of the poor, who pioneered public health initiatives in the most difficult and conservative of times.

In an Irish Republic worthy of the name, access to high quality public services should be a right for all who live on our island. No public service is more important than healthcare, including mental healthcare, and in no service is equality of access and quality of care more vital.

BACKGROUND Mental health is an area in which successive Governments have failed to provide an adequate level of service. This is despite the fact that 644,000 people, one in seven adults, have experienced a mental health difficulty in the past year. Moreover, the number of suicides has remained incredibly high, with between 495 and 554 deaths per year from 2009-2012.

The funding allocated to mental health is insufficient.

The overarching framework document for this sector, ‘A Vision for Change’, proposed a mental health funding target of 10% of the overall health budget. While there have been attempts made to reconfigure health spending in order to afford mental health greater priority, we continue to see funds earmarked for mental health diverted to other areas.

CURRENT FUNDING CHALLENGES Nine years on from the publication of the strategy, just 6% of the total health budget went to mental health, compared to 7.2% in 2006. To reach the budget target of 10% would require an estimated increase of €400 million.

Staff numbers in the mental health sector are likewise, and consequently, insufficient. There are approximately 1,200 fewer mental health staff now than there were in 2006. A report published in June 2015 indicated that staffing numbers were just 77% of the level recommended by ‘A Vision for Change’.

In Child and Adolescent Mental Health Services (CAMHS) the situation is more severe, with just over half of the staff required in place.

Prioritising Mental Healthcare

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‘A VISION FOR CHANGE’ PROPOSALS The proposals contained in ‘A Vision for Change’ are good ones, but they have never been fully introduced and so-called ring-fenced funding has, in some cases, not materialised.

‘A Vision for Change’ was published in January 2006 and was originally supposed to be reviewed after seven years. This is only occurring now. We believe the recommendations contained in ‘A Vision for Change’ still need to be implemented.

In line with this, we will allocate an additional €35 million to be directed towards community mental health services in year one of our plan for health. This will aim to address staffing shortfalls, with a particular focus on staffing CAMHS and ensuring that every part of the State has access to 24/7 crisis intervention services.

SUICIDE PREVENTION The new strategy for suicide prevention, ‘Connecting for Life’, also needs to be implemented. This sets a target to reduce suicide and self-harm by 10% over the next five years (based on WHO targets).

We must also ensure that the number of charities working in the area are assessed and a plan put in place to accredit them, ensuring that work is not duplicated and that they are of a high standard across the State.

Sinn Féin recognises the merits of the Suicide Prevention Authority proposed by the suicide prevention charity, 3Ts, and is favourably disposed to the establishment of such an overarching body on an allIreland basis to lead the way and set the standards for all who are involved in suicide prevention initiatives.

SINN FÉIN PROPOSALS TO RESOURCE MENTAL HEALTHCARE: ◘◘ Increase the mental health budget in year one by €35 million. ◘◘ Complete the rollout of Suicide Crisis Assessment Nurses (SCAN): these nurses liaise with GPs

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where there are concerns about patients who may be suicidal, resulting in significantly better outcomes for patients and potentially lower costs. Only 24 of the 35 nurses approved for this programme had been recruited by mid-2015. Sinn Féin proposes to recruit the outstanding SCAN nurses, at an estimated cost of €385,000.

Recruit mental health nurses specifically to liaise with homeless services commencing with 5 in year one at an estimated cost of €175,000.

Reverse cuts to guidance counsellors in schools introduced by the Government in 2012, at a cost of €14.7 million to the Department of Education, providing approximately 700 posts. Those cuts resulted in a 51.4% reduction in one-to-one counselling time.

Increase the number of inpatient child and adolescent beds. Just 58 of the 108 promised beds are open for admissions. 89 young persons were admitted to adult psychiatric inpatient units in 2014. We must open the remaining beds as quickly as possible to end these inappropriate admissions. Sinn Féin would allocate the additional €14 million needed to open these outstanding beds.

Increase the number of Child and Adolescent Mental Health Services (CAMHS) teams. In January 2015, 429 children were waiting for more than a year to be seen by CAMHS. There has been some investment in these teams but only half of those recommended in a ‘Vision for Change’ and not enough to meet the 50% increase in demand. By the end of 2014 there were 63 CAMHS teams in place, though none of them were fully staffed. ‘A Vision for Change’ recommends 77 teams. Sinn Féin proposes to introduce the remaining teams at an estimated full-year annual cost of €9.8 million.

Increase provision for people with mental health difficulties alongside intellectual disability. Just 5 of the 150 mental health intellectual disability nursing posts recommended by ‘A Vision for Change’ have been filled and no funding has been allocated for 95 of these posts. Sinn Féin proposes to recruit the full complement of posts, at an estimated additional full-year annual cost of €3.2 million.

Prioritising Mental Healthcare

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◘◘ Increase funding for counselling in Primary Care, which currently has long waiting lists.

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Counselling in Primary Care is an early intervention programme that provides medical card holders who have mild to moderate mental health difficulties with access to a limited number of counselling sessions. We need to increase its capacity and include those on low wages who often find it very difficult to access such care. Last year there were 14,407 referrals to the service and a waiting list of 1,000 patients, with 165 waiting between three to six months, despite the importance of early intervention. Sinn Féin proposes to double the numbers being seen with a further investment of €3.8 million.

Update the Mental Health Act and Criminal Law (Insanity) Act to bring them into line with international human rights standards.

Extend the Health and Social Care Professionals Act to provide for the regulation of psychotherapy and counselling.

Prioritising Mental Healthcare

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