Below is a letter from the President to major political party leaders sent yesterday, regarding Mental Health Services and the next Programme for Government in light of Covid-19
Today the United Nations and the World Health Organisation highlighted that mental health needs must be treated as a core element of our response to and recovery from the Covid-19 pandemic requiring an ‘urgent increase of investment in services for mental health’ or ‘risk a massive increase in mental health conditions in the coming months’.
The College has great concerns about the impact the Covid-19 pandemic is having and will continue to have on an already overburdened, underdeveloped Mental Health Service in Ireland, both in hospital and community settings, and the ability to deal with the mental health needs of our country in the near and distant future. While there have been many excellent service improvements implemented nationwide over the last decade, it is well known and documented that multi-disciplinary, recovery oriented, individual based care is patchy and insufficient nationwide. The deficits and shortcomings across mental health services, due to a myriad of documented reasons, have become more pronounced with the advent of Covid-19.
Now more than ever, it is incumbent on the next government to focus urgently on support and recovery for those with mental illness and place Mental Health Service development and provision to the fore of Health Service development. At the very least, plans and actions must be on a par with and integrated with development and sustainability of physical health care delivery. We reiterate that for every euro spent on mental illness interventions and supports four euro can be potentially saved, as has been proven in the UK.
Twenty-five percent of our population at any one time are affected by a mental health disorder. That figure is set to increase due to the Covid-19 pandemic.
Some sectors of mental health services are already seeing new referrals as a direct result of the stress and circumstances caused by the coronavirus restrictions and subsequent isolation and anxieties around it.
Preliminary data from the recent NUIG / DCU ‘Corona Citizens Science Project survey’ suggests that well-being and mental health have been negatively impacted by the pandemic when compared with the Healthy Ireland Survey of 2016. The initial findings also indicate that the negative effect of the pandemic appear to be greater for younger people’s mental health and well-being as compared to older people.
As you are aware, Child and Adolescent Mental Health Services (CAMHS) that treat moderate to severe mental illness in young people, currently operate with 65 percent of the teams required in Ireland. Those teams operate at only circa 55 percent of the staffing complement required by the multidisciplinary team nationwide. CAMHS consultants are already experiencing significant levels of burnout and stress. A recent survey of Child & Adolescent psychiatrists by Prof F McNicholas, through the College, found that work related burnout was the highest, with 3 in 4 respondents having experienced significant burnout, and 2 out of 3 reported emotional exhaustion (see attached). The aftereffects of Covid- 19 are likely to see levels further exacerbated. An urgent focus on fulfilling the needs of this service to ensure our future generation are given the best possible support and treatment to enable them to lead full lives will be essential. They are the cohort who will lead the country’s recovery – economic, social and emotional – from Covid-19 for decades to come.
The mental health of healthcare professionals, including mental health professionals, already working in a stretched health service, is and will be affected by Covid-19 potentially hindering their ability to carry out their professional roles as before.
A new curve will need flattening as part of the social contract Irish people will expect of the incoming government. The next programme for government, as well as promoting good mental health in society, must firmly prioritise providing for the mental illness of our nation. To provide equitable, accessible, high quality services and supports for those suffering with mental health disorders we need:
- A national cross sectoral taskforce now and post Covid-19 to address the mental health ramifications of the virus.
- A national urgent effort to address the recruitment and retention crisis in Mental Health Services. This is more crucial now due to the impact of Covid-19. Before Covid-19 there were 100 vacant specialist (consultant) posts.
- Our workforce planning indicates a minimum 800 specialist psychiatrists are required by 2023. We are not even halfway to achieving this figure. We need sufficient psychiatrist training posts from foundation year to final higher specialist training to ensure specialist / consultant posts can be filled in the future and in line with projected population growth.
- An immediate doubling to at least 12 percent of the overall Health Budget allocated to run and continue development of Mental Health Services, as well as bringing us in line with our other similar jurisdictions. 1 billion euro currently allocated only represents circa 6 percent of the Health Budget. Funding of Mental Health Services and any reallocation of those budgets should remain within those services.
- Independent monitoring, which tracks progress and provides transparency of not just budgets and funding but outcomes for patients achieved and where not achieved, adjustments required.
- National leads on cabinet, in government departments and in the HSE are needed, such as a Super Junior Minister for Mental Health and a Mental Health Director who sits on the HSE leadership team.
The College is setting up a group to assess and collate the effects of and learnings from Covid-19 across psychiatry specialties on how we deliver care and support to our patients and families, with the aim of informing government and policy development. The College will be adopting an overarching theme for our activities and mission on ‘Right to Treatment’ from 2021 which will no doubt now be influenced by findings from our assessment of this coronavirus.
Psychiatrists, trainee psychiatrists and their teams operating during Covid-19 restrictions will continue to adapt, adjust and deliver services in a safe manner for their patients and teams.
The next government has a real opportunity to change and shape how we support and care for those with mental illness in Ireland and to leave a legacy of success where every Irish citizen has an equal right and ability to lead full, socially and economically productive lives.
We urge you as leader of your party to ensure mental illness care and support is priority for our next government. The College can provide leadership and is available to support and advise the next government in their deliberations to achieve this.
The new Ireland post-Coronavirus will expect a society that recognises and ensures mental illness is given, at a minimum, parity of esteem and integration with physical healthcare.
The WHO leadership has been invaluable to how this country has dealt with the crisis to date. Following their lead now on the urgency of dealing with the mental health illness and difficulties of our nation is paramount.
Yours sincerely,
Dr William Flannery
President