June 18, 2009

AMNESTY INTERNATIONAL is the latest agency to draw attention to the woefully inadequate psychiatric services being provided for those who experience mental health problems in this State. Its involvement could, however, give a considerable impetus to a long-running campaign for the supply of a basic range of treatments because it is threatening to invoke international law in order to force the Government and the Health Service Executive (HSE) to meet their obligations.

It should not have to be like this. But the Government and the HSE have been so lax in their response to a worsening situation that nothing short of international opprobrium may change their behaviour. Even when an increase in funding was granted to improve psychiatric services, much of the money was siphoned off by the HSE for use elsewhere. An indication of how these important services have been neglected can be gained from the fact that the proportion of health funding spent on mental health has fallen from 23 per cent in 1966 to less than 7 per cent this year.

Suicide prevention is of particular concern. Mental health problems can be closely related to suicidal behaviour. Ireland has the highest rate of youth suicide within the European Union. Irish men are four times more likely to take their own lives than their English counterparts. In spite of that, the Oireachtas Committee on Health found that fewer than one-in-four of the recommendations made three years ago in a special report on suicide prevention had been implemented. And the number of people who die in this way continues to rise.

The Irish legal system traditionally used prisons as a dumping ground for citizens with psychiatric problems. In its brutal pragmatism, it was as crude and as uncaring as the committal of young children to reformatories. Condemned by prison chaplains, it still goes on. Where psychiatric units exist, they are starved of resources. A new Central Mental Hospital has been promised for years. But there is no sign of one being built. Instead, staff members at the hospital warn it may cease accepting patients within a matter of days because of a shortage of nurses.

Health services are generally configured around the requirements and status of those who work in the system, rather than the needs of patients. Executive director of Amnesty International Colm O’Gorman said they intend to use human rights and international law to demand change. They want to put the person at the heart of the system. That is the way to go.

This article appears in the print edition of the Irish Times