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Dublin: 6 °C Tuesday 18 June, 2013

Column: Last year’s multi-million euro underspend in mental health is unacceptable

In a year when many families and communities lost a child or young person to suicide, it makes no sense that €29 million pledged to be spent on mental health was not used, writes Tanya Ward.

Tanya Ward

YOU MAY GROW out of almost everything in your life, they say, but never your childhood. This is why we place a value on childhood and it is why investing in young lives is vitally important – not only for children themselves, but for society at large. This is an age-old and well-accepted pearl of wisdom.

Yesterday, the Children’s Rights Alliance launched Report Card 2013, the fifth edition of our annual series, which scrutinises Government progress on its commitments to children as set out in the Programme for Government 2011-2016. We all know that you should never, ever make a promise to a child that you cannot keep – which is why we try to find out if the Government is doing what it pledged for children.

Mediocre grades

We awarded Government an overall ‘C’ grade for their work in 2012. Of the twenty commitments we track, the awards were a mixed bag, ranging from an ‘A’ for the children’s referendum to an ‘F’ for child poverty. And in-between there were many mediocre grades.

As always with these things, the devil is in the detail. Take the chapter on the right to health, which got a disappointing ‘D’ grade overall. Four commitments were tracked and each got a variant of a ‘D’ grade. The Report Card explores whether progress has been made, and if not, why not?

Take the case of ‘Primary Care’. Here, the Government promised in July 2012 to recruit 272 front line health staff, including public health nurses and speech and language therapists, and it pledged €20 million to fund these posts. By the end of 2012, no post was filled and the funding was redirected elsewhere by the HSE. The Government also pledged to remove GP fees on a phased basis beginning with those with long term-illnesses, a move that would hugely benefit children and families access to healthcare.

Budget 2012 allocated €15 million for this reform but as necessary legislation was not in place, the funds were used to make up financial deficits in the HSE. We were quite shocked by this and frankly, we believe that it is unacceptable. Monies promised should be ring-fenced for their rightful purpose. To do otherwise, is not fair and is like stealing the promises you have made to children and families.

Mental health

The story gets even murkier when you look at ‘Mental Health’. To be fair, during 2012, there were some notable positive steps to improve mental health services to children. For us, these were however overshadowed by the fact that, of the €35 million of funding promised and allocated for community mental health teams, only approximately €6 million was spent. As with primary care, the remaining millions of euro were used to tackle cost overruns in other parts of the health services.

To me, it beggars belief that this could happen, especially in a year when many families and communities lost a child or young person to suicide. We all know that urgent action is needed to combat bullying and suicide among Ireland’s youth. The 2012 My World survey found that nearly 10 per cent of adolescents and 20 per cent of young adults reported significant personal problems they felt needed professional help but did not seek it. I did not think that the critical importance of an effective and accessible national mental health service for children and young people needed to be spelt out – but perhaps it does?  How €29 million pledged to be spent on mental health could not be used as planned requires immediate answers from the Department of Health.

But this is not just about the Department of Health. If Government wants to make Ireland one of the best places in the world to be a child then each Government department has to play its role and prioritise children effectively, investing vital funds to make a real difference to children’s lives. They need to work like a team and strive to be at the very top of their game. As Report Card 2013 has once again shown, it is not enough to just make promises. Keeping your promises to children is the key.

Tanya Ward is the Chief Executive of the Children’s Rights Alliance.

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Comments (29 Comments)

  • Sickens me, we have a little girl who needs the services of CAMHS and early intervention, we were waiting about 9mths last year to see a clinical psychologist as there wasn’t one in Galway early intervention services, the staff member in question had taken extended leave. The existing staff were told that because of the embargo on recruitment they couldn’t look to fill the vacancy on a temp basis. We came close to losing a place in the special needs unit which in turn came under threat as the numbers were below the threshold. It meant would could not get access to services to help our little girl, and then they use the budget elsewhere, so yes I will give out about over and underspending

    Reply
    • Your situation is endemic throughout the country. Huge waiting lists, HSE frontline services understaffed and under resourced, Children being inappropriately placed in adult services after they are eventually assessed are only some of the downfalls. I sincerely wish you and your child luck with the leviathan that is a very broken service this HSE.

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    • Feel your pain Vincent. So bloody frustrating.

      Reply
  • I agree with this article, the state of the healthcare services is a joke in many of its parts. …

    Just one minor side note – I find the term “the right to health” a bit misleading. Health is a blessing and illness naturally comes at some point. What should be available for people is fair access to healthcare equally offered to everyone (and not based on how much you have in your pocket). I call it the right to be treated fairly and not having to feel like there are certain people who are for some reason privileged in getting what they want. It’s the same principle like the right to free speech or assembly, everyone is supposed to be treated the same. “The right to health” sounds a bit silly to me. “The right to fair treatment” reflects the reality more, in my view anyway.

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    • I agree.
      We actually have a 3 tier health system here.
      Those that have private health insurance and those that have medical cards. Then we have the rest who have neither.
      I’ve been in the system all my life, I have a chronic illness, and have had to pay for all my meds and GP visits up until last year.
      I now have a medical card, as I’m a cross border worker. My irish card is paid by the tax I pay in the UK.
      The difference it’s made to my family finances is unbelievable.
      The services provided by a medical card should be available to all. If someone want to pay privately, let them. But the opportunity to avail of services shouldn’t be down to financial restrictions.
      I recently had a major operation. After, I needed post op care from a district nurse. Whether I got this care depended on if I had a medical card or not. I got the care, but if I hadn’t had the card, I wouldn’t have got it.
      I couldn’t drive, but I would have been left on my own to deal with my aftercare.

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  • Terrible that money allocated to this health service did not make it. Have to agree with others on this forum this is not a place for jokes and we should be kicking the gates of the Dail asking the same question. What the f..k are u doing with our money ???

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  • my daughter has been suicidal for 2 months now and we are still waiting for a place for her in hospital. GP and the nearby health centre have been helpful and have referred her to specialist services.
    Having private health insurance hasnt made a difference. No wonder we have such a high rate of suicide among teenagers. As a family we are at our wit’s ends and she’s suffering needlessly.

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  • sean 19/02/13 #

    When you such stuff as this story, regarding money in the use
    It would make U wonder
    http://www.irishexaminer.com/ireland/hospital-cant-explain-700k-top-up-fees-to-5-staff-223079.html
    (not saying its Linked , just highlighting the sort of crap that is allowed to happen Willy nilly in the boardrooms of the hse )

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  • What really worries me now is what the Government is going to do with this € 29 million left over????????? Will it go into thirs pockets or… ?

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  • The money was/is being used for the EU presidency, 35 million was only spent by the Last Country to host it and I am not sure If it was Denmark or another? Ireland is spending 60-70 million on it, do your sums!

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  • Isn’t it true that if you underspend on a budget that you loose the money next year

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  • Shocking and utterly disgraceful.

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  • Thoughtful piece Tanya, you are spot on! These are some of the worst cuts so far, anyone affected would agree. Gross misconduct

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  • Each night of TV viewing has a detrimental effect on mental health. Many people are not mentally robust enough to consume violent and smutty programming nightly without effect. If material is not fit for children how is it suitable for adults.

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    • I agree completely. Tv shows a version of reality that is largely violent, cruel and vindictive. I haven’t had one for years and think its probably the best thing I’ve done for my kids. Anyway, teaching kids that it’s healthy & normal to sit glued every night to a flashing advertising box is IMO just wrong!!

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    • I agree as well. I decided not to bring a TV to my new place six years ago and have felt quite liberated since then.

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  • We over spend people are giving out, we underspend people are giving out!

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    • No, when we underspend massively..we give out, like this article

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    • When credit is claimed for taking care of our vulnerable, only for it to turn out that the ‘care’ was in name only – it’s appropriate to name & shame.

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    • I agreed, when there is wasteful overspending we should be complaining. However, there was allocated money to provide a medical service and it was not provided. I’d suggest that instead of trying to be witty and cleaver we should be outraged that other Irish citizens are being deprived medical care and their rights.

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    • sean 19/02/13 #

      Its not a case of over/underspend , the question remains
      Where did the €29m go to
      Bondholders,
      Td and senator expenses,
      bankers bonus,s
      Top civil service pay
      Government advisor,s
      Because it definitely did not go to helping children in any shape form or fashion .

      Can,t wait to hear what epic fail health minister o,Reilly,s side splitting explanation

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    • * agree
      * clever

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    • The underspend is due to the fact that there is an embargo on recruitment so the government allocates funding while not allowing the hse to spend it. It’s psychiatrist nurses etc that are needed to improve level of services but our hands are tied behind our backs.

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  • I’m deeply skeptical about calls for increases in funding for child mental health services. If this works, it’s a link to Louis Theroux’s “America’s Medicated Children”. Okay, it’s a television documentary rather than an academic study but it paints a frightening picture of where we mighe be going.
    http://www.youtube.com/watch?v=G8k0iw1Kon4
    The amount spent on child mental health should be small, as bone fide psychiatric illnesses don’t normally present before the mid to late teens. Of course there are always outliers.
    More specifically child-centred services are a different story. I would include maternity and postnatal care in this category, as well speech and language therapy.
    As for 10 per cent of adolescents thinking they’d benefit from “professional help”, this may be because they don’t realise the differencce between the plots of “Home and Away” and reality. Adolescents “think” lots of things but we would be doing them a disservice by basing public spending decisions on their input rather than making reasoned and responsible decisions like the adults we are.

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    • No Jone, the money was allocated to community-based mental health services that are supposed to be used to fund a new, more enlightened approach that is moving away from the ‘medical model’… to implement A Vision for Change, which the Government have been promising for years to implement: A Vision for Change (AVFC) proposes a radical change in ethos and approach to the provision of mental health care. See
      http://www.mentalhealthreform.ie/
      Nobody wants medicated children. However, listening to young people and taking them seriously when they talk about their distress and what they need is never a waste of time. Our country does rather specialise in the authoritarian we-know-what’s-best-for-you approach but I do not agree with it. Have a look at this survey of more than 14,000 Irish adolescents on mental health – http://www.headstrong.ie/sites/default/files/My%20World%20Survey%202012%20Online.pdf
      It seems to me they are very clear about what makes them stressed and unhappy and also about what can make it better – time we listened perhaps? That way we could support our adolescents to learn how to look after their own mental health, and offer them person-centred supports when they need them, and so create adults with better emotional resilience. These are, after all, life skills… Could save the HSE a fortune in the future too!

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    • Those community-based mental health services are supposed to be aimed at adults and older teenagers; not children.

      Reply

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