LEGISLATION SHOULD be passed to force improvements in mental health services here, an international expert on health rights has said.
The UN Special Rapporteur on the Right to Health, Anand Grover, was speaking at a conference hosted by the Irish Mental Health Coalition in Dublin yesterday.
The conference, titled Mental Health: Human Rights and Legislation. What's Possible in Ireland?, heard that under international law all people had the right to the best available mental healthcare.
Mr Grover said the HSE's A Vision For Changedocument – a national implementation plan for mental health services published in 2006 – was "without a doubt a very important policy document radically changing the way the mental health service is viewed in Ireland".
“I have a number of serious concerns about its implementation, however,” he said.
" Vision For Changerequires legislative backing. There has been no legislation in order to implement this policy."
Such legislation would enable people who were not receiving services outlined as their right in the document the power to go to court demanding them.
Mr Grover said the suggested allocation of €150 million over seven to 10 years was inadequate, while the timeframe of implementation was “far too unspecific”.
He said a key recommendation of the document had been the establishment of four child-appropriate in-patient facilities, although by April 2008 “there were still none to be seen”.
“Budgetary allocations are still mainly focused on institutionalised care rather than on community-based care, and spending on mental health services has actually dropped over the past few years.
“Figures show that the proportion of the health budget spent on mental health fell from 13 per cent in 1984 to 7 per cent in 2008.”
He said this represented “retrogression” in mental health policies here.
“Also due to budgetary considerations, a high number of vulnerable patients remain in long-stay wards, living in unacceptable conditions. It means the right to health and other human rights are being infringed.”
He said an implementing authority should be appointed by the HSE as soon as possible. Among other measures he called for were the participation of people with mental health difficulties in decisions affecting them.
Mary Keys, of the school of law at NUI Galway, called for the swift appointment of a National Mental Health Services Directorate, saying the Visionblueprint "cannot be implemented effectively" without it.
She said though people were not being committed to large institutions, little had changed when one considered how people were being committed to nursing homes or other long-stay accommodation due to a lack of appropriate care in the community.
John Redican, executive officer of the National Service User Executive, said the largely medicalised basis of the Irish mental health service was not always appropriate and at times infringed on a person’s citizenship rights. He cited the example of medication that could affect a patient’s fertility.
