Address by Mr. Tim O’Malley, T.D., Minister of State at the Department of Health and Children at the EVE Conference

At the outset, I would like to thank Dr. Webb for her kind words of welcome. I would also like to express my warm gratitude for the kind invitation to be here with you this morning. This occasion gives me the opportunity to see at first hand the determination and commitment of the people at the Eastern Vocational Enterprises Ltd (EVE). EVE, as you know, is a subsidiary company of the Health Service Executive, which provides a network of training and employment services for people who experience mental health difficulties in Dublin, Wicklow and Kildare.

The theme of this conference “Partnership and Empowerment in Mental Health Services” – developing meaningful partnerships in recovery-oriented services is very appropriate at this particular time in the development of mental health services in Ireland.

As you are aware, “A Vision for Change” – the Report of the Expert Group on Mental Health Policy was launched in January. This report is the first comprehensive review of mental health policy since Planning for the Future was published in 1984. It sets out an exciting vision of the future for mental health care in this country and a framework for action to implement this vision over the next 7 to 10 years.

The Group undertook a wide-ranging and comprehensive public consultation process. The findings from that process, which were published in two Reports in December 2004, are central to the framework outlined in “A Vision for Change”. This consultation made clear the service users’ views in relation to the present state of the mental health services and how they should be developed in the future. I know that EVE, through their General Manager Dr. Webb, and another of your speakers here today, Professor Chris Stevenson were valued members of the subgroups which informed the work of the Expert Group.

Throughout the consultation process there was a universal call for significant change at all levels of service provision, and in particular for the delivery of community-based interventions that are accessible, user-friendly and effective in promoting recovery and re-integration. The necessity of involving service users and their carers in all aspects of service delivery was a key message and this is the foundation on which “A Vision for Change” was built.

Thankfully, there is a growing awareness among service providers that establishing a good quality of life for patients requires their involvement in the planning of the services that are important to them and which support their choices. The perspective of the patient and their families needs to be understood and appreciated. The vision that guides this policy requires that mental health services be characterised and led by a partnership between all stakeholders. A comprehensive mental health care system requires that services at all levels – from community support groups, to voluntary groups, to primary care, to specialist mental health services – work in an integrated, coordinated fashion for the benefit of all people with mental health difficulties.

“A Vision for Change” proposes a holistic view of mental illness and recommends an integrated multidisciplinary approach to addressing the biological, psychological and social factors that contribute to mental health problems. A person-centred treatment approach which addresses each of these elements through an integrated care plan, reflecting best practice, and most importantly evolved and agreed with both service users and their carers is proposed by the Group.

One of the fundamental principles of the report is ‘recovery’, in the sense that people with mental illness can and should be facilitated in reclaiming their lives and becoming involved in society – i.e., to be ‘socially included’. To achieve this, people need supportive mental health services, but they also need supportive communities where actions are taken to address basic needs such as housing, employment and education. All of these elements are included in the vision for the future outlined in this report.

A modern healthcare accepts that each person must play a central role in their own treatment of recovery. It recognises that each individual plays a critical and essential role in the assessment of their own needs and that quality of care is inextricably linked to the involvement of the user in determining their health care.

This policy envisions an active, flexible and community-based mental health service where the need for hospital admission will be greatly reduced. The Expert Group has indicated in this report that Community Mental Health Teams should be the cornerstone of mental health service delivery. It has recommended that well-trained, fully staffed, community-based, multidisciplinary teams be put in place in all services, providing mental health care across the individual’s lifespan, from childhood to old age.

Employment and training are core requirements of service users attending a rehabilitation service and it is in these two areas that the rehabilitation team must develop close links with existing statutory and voluntary agencies. According to the National Disability Authority (2005), people with mental health difficulties are least likely of all the disability groups to gain employment in the open labour market.

People go to work for various reasons, economic gain, self-esteem, stature and respect in the community. In order to facilitate people with enduring mental health difficulties achieve employment, it is necessary to promote a flexible view of the workplace and accommodate a variety of “employment models”. Where individual programmes are devised for the person, with the proper assistance it will mean that in many cases a chance of gaining employment and maintaining employment is a realistic goal.

I see from your agenda that the ‘Clubhouse’ model will be discussed in a workshop session later this morning. As some of you may be aware, the first clubhouse to be established in Ireland was opened in July 1999 under the auspices of Eastern Vocational Enterprises Limited. The Clubhouse concept originated in New York over 50 years ago and offers members a supportive environment in which they can work alongside staff in planning and operating the Clubhouse. The Clubhouse is an innovative, member-run and centred service with clients gaining self-confidence by participating in a work oriented programme. It offers members a supportive environment in which they can work alongside staff in planning and operating the Clubhouse.

Members of the Clubhouse can, for example, participate in preparing meals for all those that attend, they can learn office and computer skills and organize social outings. The aim of the model is to provide involvement and empowerment and help people to remain out of hospital while achieving social, financial and vocational goals.

The stresses and pressures associated with every day life combine in many cases with difficulties in coping with significant life events such as bereavement, unemployment and interpersonal relationship problems. Almost every family in Ireland has had or will have some experience of mental illness. Mental illness does not just affect the sufferer it also affects the person’s family, friends, employer and colleagues. To experience a relative, friend or employee who suffers from a mental illness can be confusing and traumatic. Education and training is the cornerstone to advancement in the understanding of mental illness and improvements in methods of care. Heightening awareness will assist in eliminating many of the prejudices and misconceptions that surround mental illness.

In conclusion, I would like to congratulate everyone involved in this conference and wish them continued success in developing an important and supportive mental health service for their members. The Eastern Vocational Enterprise Ltd and its staff are to be commended for their efforts in promoting change for the betterment of the community.

Thank you