Mental Health Commission’s Report Exposes Disparities Between Public and Private Mental Health Care

The Mental Health Commission has published its 2021 Annual Report this week.

Commenting on the report, Róisín Clarke, Interim CEO, Mental Health Reform said: “We welcome the publication of the Mental Health Commission’s annual report which provides key insights into Ireland’s mental health system.

The report highlights an urgent need to reform and improve investment in the delivery of mental health services. It is unacceptable that independent private inpatient mental health centres offer a better level of care than facilities in the public system. The two-tier system is endemic across our healthcare system which is causing inequities for individuals with mental health difficulties.

In 2022, the national mental health budget represents just 5.5% of the total health budget. We are calling on the Government to increase spending to 10% of the total health budget by 2024. Funding is essential to ensure that all people have access to high-quality, timely mental health care regardless of their financial means.

The increase in the admission of children to adult facilities is deeply troubling. In 2021, there were 32 admissions involving children to adult units compared with 27 admissions in 2020. 31% of child admissions occurred when there was no bed available in a CAMHS unit. These findings are especially worrying given the ongoing crisis in the provision of CAMHS services nationally.

The admission of a child to an adult inpatient unit is in contravention of their human rights. We are calling for the reform of the Mental Health Act to prohibit this practice. The reform of our mental health legislation must be progressed urgently to protect the rights of children and young people who access mental health services.

Findings in the report also show an increase in seclusion in mental health centres. This is a practice that can have harmful physical and psychological effects. Our national mental health policy, Sharing the Vision recommends a zero restraint, zero seclusion action plan.

It is extremely concerning that applications to involuntarily detain people by An Garda Síochána have increased for the third consecutive year. An Authorised Officer should be the only person to sign applications for involuntary admission to an inpatient centre. Additional funding and resources are required to increase the number of Authorised Officers. We cannot allow applications by the Gardaí to continue.

Overall, the report demonstrates the need for stronger accountability and governance across the health service. Mental Health Reform is calling for the reinstatement of a National Lead for Mental Health in the HSE to report directly to the CEO of the HSE. This role is critical to ensuring oversight and leadership in the improvement of mental health services.”

The Mental Health Commission’s 2021 Annual Report is available here.

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