Monday 16 March 2015

The light at the end of the tunnel is the community based services...

HSE's mental health 'Vision' under the spotlight

Monday 16 March 2015 11.05
Anne Foley credits community based mental health services for her recovery
Anne Foley credits community based mental health services for her recovery
Figures obtained by RTÉ show that just 24% of the mental health posts allocated for last year have been filled or accepted. 
Mental Health Reform has highlighted rising waiting lists and a lack of 24-hour community care for people with mental health issues.
 RTÉ's Aisling Kenny examines the figures

That is despite a Government promise to put a greater focus on this type of care.
The Government's mental health policy 'A Vision for Change' promised more resources for community based services, in order to minimise hospital stays and help reduce stigma.
Anne Ellis's son Shane suffers with depression along with psychotic episodes.
"I remember the fear in my heart and the panic, just a broken heart..."
One Sunday night in April last year, Shane tried to take his own life for the fifth time.
Anne took him to a nearby emergency unit but was told there was no psychiatric bed available for her son.
"I remember the fear in my heart and the panic; just a broken heart because I knew looking at my child he didn't want to be here any more. He was very unwell, complete low mood and he had taken a lot of his medication so he was very unwell," she says.
"He had just been out of James Connolly Psychiatric High Dependency Unit where he had spent three months.
"I took him to A&E and I was told, after sitting in A&E for up to eight or nine hours, that unfortunately there was no beds in James Connolly hospital. 
"I asked them to source a bed in Dublin or anywhere throughout the country and I was told that I had to take him home," Anne adds.
Shane avails of community-based mental health services in Finglas in Dublin.
However, these services are limited and are only available from 9am-5pm Monday to Friday.
"What is needed is 24-hour psychiatric intervention services, that at 5.30 on Friday if Shane becomes unwell, which can be a reality for anyone living with a mental illness, it can come on very quickly, to be able to bring him to a centre that could assess him. 
"With someone when their mind becomes unwell the A&E service is just not working for people presenting with self harm and who are suicidal," she says.
In a statement, the HSE said it is HSE policy and best clinical practice, to admit patients on a voluntary basis where clinically indicated.
It said a patient may refuse to be admitted and in some cases the clinician will use the Mental Health Legislation to involuntary admit a patient if clinically indicated.
It said there is nothing to suggest that a shortage of beds on the date in question in April 2014 was the reason a person was not admitted.
Mental Health Reform, Shari McDaid says a lack of funding is having a major impact on multi-disciplinary community based services:
"We don't have the staff on the ground to be able to provide the community based follow up.
"So what that means is that someone who has been in acute distress, who may have been in hospital for a little while, or may have shown up in A&E with a significant issue, but maybe didn't need to be hospitalised they may not get that follow up support in the community as quickly as they should get," Ms McDaid says. 
"There may not be a community health nurse available, they may not be able to access the psychological therapy that they might want in order to work through their mental health issue," she adds.
Figures show that at the end of last year there were over 3,000 children and teenagers waiting to access mental health services in the community and over 400 of these were waiting for over a year.
Meanwhile, figures obtained by RTÉ's Morning Ireland show that just 61 out of 251 mental health posts that were approved for last year have been filled or have been accepted.
Specifically in relation to psychology and nursing posts just 49 of the 101 posts allocated for 2014 have been filled.
In a statement, the HSE said the mental health division is acutely aware of the the need to focus on recruitment of front-line staff.
Sinn Féin's Caoimhghín Ó Caoláin says it is taking years to fill posts in the community mental health area.
"The extra monies that were committed to by Government in 2011, 2012, 2013, 2014, and again this year, were specifically about providing additional resources in order to facilitate the role out of the promise in the Vision for Change, he says. 
"Now the Government committed €35m in 2012 with the promise of 416 additional posts, but when you explore the facts behind these figures you will find that the 416 posts are still not filled.
"At the turn of this year they are nearing completion of the 2012 recruitment process with 397 or 95% of the promised 416 post at the end of November 2014, Deputy Ó Caoláin adds.
"It's like living in a black hole. There are times when you don't want to get out of bed..."
Anne Ferris, from Co Wexford, suffered with severe depression for a number of years, and after hitting rock bottom in 1999, she was admitted to psychiatric hospital.
"It's like living in a black hole.There are times when you don't want to get out of bed. There are times when you don't want to wash yourself, there are times when you don't want to eat, there are times when all you want to do is cry, you want to be on your own but yet you don't want to be on your own," she says.
"When I was going through the worst of it I just used to say 'please God get me through this'.
"If I was after taking an overdose and sometimes I'd do it without even thinking and I'd turn around and say please God help me to make this call for help," Anne says. 
"They looked at me as a whole person in that they looked at my whole situation..."
The light at the end of the tunnel came for Anne a number of years ago when she began availing of community based services in her local area.
"My life saver - was my day hospital - which is called Maryville in New Ross.
"The psychiatrist who was there decided that all the medication I was on I didn't need to be on it, he started weaning me off it," she says.
"They looked at me as a whole person in that they looked at my whole situation - not just my psychiatric illness, they looked at my family situation and how I felt about getting sick and losing my kids.
"As my weight was going down and as my medication was being decreased my mood started to go up," she says.  
Anne, who is now involved in community based mental health services in New Ross, believes that having these services available saved her life.
"Look beyond the text books, look beyond the labels and see the person as whole person," she says.
"Yes they have an issue, but if we can see that they have an issue, and we can help them deal with it, and let them see that there is light at the end of the tunnel, and the light at the end of the tunnel is the community based services," Anne says.

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