Address by Mr. Tim O’Malley T.D., Minister of State at the Department of Health and Children at the launch of the Reports on the Consultation Process by the Expert Group on Mental Health Policy

I am delighted to have been invited here today by the Expert Group on Mental Health Policy to launch the two reports on the Consultation Process. The reports are very aptly entitled Speaking your Mind and What we Heard.

Speaking your Mind, prepared by Carr Communications, who facilitated the public consultation process, provides a very comprehensive overview of the three part consultation process which comprised written submissions, questionnaires and two public consultation days.

The second Report, What we Heard is the result of a comprehensive one-to-one consultation process with service users in the Adult Mental Health Services which was undertaken by The Irish Advocacy Network on behalf of the Expert Group. Both Reports provide a very clear message to policy makers about the type of mental health services that are needed for the future: services that are person-centered, accessible and of a high standard.

Most of us would have to agree that people with a mental illness are among the most vulnerable groups in our society. For many years, people with a mental illness were excluded from full participation in community life as a result of the widespread stigmatisation of mental illness. Thankfully, there is now recognition of the right of each person to participate fully in the social, economic, political and cultural activities of their communities.  Recognition of that right is vital if we are to build an inclusive society in which all of our citizens can contribute their experiences, talents and abilities. The core principle underlying this policy is that people suffering from any form of ill health should be enabled to live as independently as possible.

This was acknowledged as far back as 1984 when “Planning for the Future” recognised that old institutional mental hospitals are unsuitable for the delivery of a modern mental health service and developed the concept of a comprehensive community orientated psychiatric service. On foot of the recommendations of that landmark report, recent years have seen dramatic changes in both the concept and practice of mental health care delivery in Ireland. The perception of an institutional style mental health service, standing in isolation and closed from the rest of the community, is thankfully becoming a thing of the past.

Enormous strides have been made and continue to be made in developing a service which is comprehensive, community-based and integrated with other health services.  Substantial progress has been made in ensuring that those in need of mental health services receive care and treatment in the most appropriate setting. Undoubtedly the quality of care for many people with a mental illness has been enhanced by this development.  Many of you here today will have experienced and indeed contributed to this change in the delivery of services, which has brought about many improvements in patient care.

I accept that much still remains to be done. The Government is committed to the provision of quality care in the area of mental health, to upholding the civil and human rights of those who suffer from mental illness and to encouraging measures aimed at combating the stigma that is often associated with such illness.  During my term of office as Minister of State with special responsibility for mental health, I am endeavoring to continue to accelerate the growth in more appropriate care facilities for people with a mental illness through the further development of community-based facilities throughout the country.

Our health and personal social services, including the mental health services, are and must always be, first and foremost, about people – the patients and clients who receive the services and their families, and all the staff who provide those services. We live in a society that is consumer oriented.  All State services, including the mental health services must be responsive to this trend.  The consumer in the psychiatric service is the patient and his or her family and friends.  Just as the power of the consumer has made itself felt throughout the market economy, so is it now being felt in the mental health services.  The growing service user movement in mental health is yet another strand to this development, and one which I welcome. I am delighted to see that the Expert Group has upheld this principle throughout its consultation process.

I see it as a key task of the health services not just to treat mental illness but more importantly, using the principles of health promotion, to try and improve the mental health of the population at large.  Mental health promotion is a very broad concept as it emphasises the promotion of the psychological health and well being of individuals, families and communities.

Good mental health is an integral component of general health and well-being, which allows a person to realise his or her abilities.  With a balanced mental disposition, one is more effective in coping with the stresses of life, can work productively and fruitfully and is better able to make a positive contribution to his or her community.

Unfortunately people’s experiences with mental healthcare services vary from exceptional standards of care and treatment to poor and less than satisfactory care. As a consequence these imbalances contribute to and sustain an uneven spread of strengths and deficiencies in service delivery. We must all aim to make delivery of mental healthcare more equitable and effective countrywide, and recognise that a collaborative approach represents the best way forward for both the service user and the service provider.

Since coming to office, I have taken the opportunity of visiting a number of psychiatric hospitals and have seen at first hand the commitment of staff to the provision of a high quality service. From the outset, I accepted that further investment was required to upgrade or replace some of the physical facilities and that greater capital investment was required to provide a community-based infrastructure.

Public health care systems worldwide are facing unprecedented challenges. Expectations are rising and changing demographics and lifestyles are creating diverse needs. The challenge facing everyone is to create quality health and social gain in a comprehensive and equitable health care system. Developing psychiatric services to meet the challenges of today’s and the future’s health care environment is essential for a health care system that is responsive to the social determinants of health as well as lifestyle, behaviour and illness patterns.

As many of you will be aware, the National Health Strategy, “Quality and Fairness – A Health System for You”, gave a commitment that a national policy framework for the further modernisation of the mental health services would be prepared, updating “Planning for the Future”. The establishment of an Expert Group to undertake this task was a very significant milestone.

The Group, chaired by Professor Joyce O’Connor, President of the National College of Ireland, includes representatives of the medical, nursing and paramedical professions, voluntary bodies and mental health service users. The membership therefore encompasses a wide range of knowledge and a balance of views on many issues affecting the performance and delivery of care in our mental health services. I know that this diversity of disciplines has been of great assistance to the Group particularly in the establishment of a range of Advisory Subgroups to examine specific areas of the mental health services.

I know that the Expert Group has an ambitious target of completing its deliberations by June of next year. Its recommendations will be central to the work of driving the agenda for change and modernisation in the Irish mental health services in the coming years.  I would like to thank all of you who have already contributed to the preparation of the new national policy framework by participating in the consultation process and also for taking the time to attend the launch today. You, as contributors to the work of the Group, are uniquely placed to ensure that the service takes on a more people-centered approach. The extensive consultation process undertaken by the Group has provided you all with the opportunity to be a force for change in the way services are delivered.

In conclusion, I would again like to stress the Government’s commitment to the development of services for those suffering from mental illness. I am determined to build on the substantial progress to date so that we can all work together to bring about a mental health service worthy of the Ireland of the 21st century.

Thank you