MENTAL HEALTH CONCERNS us all and most of us have experiences of requiring help for ourselves or a member of our family. Being unwell forces one to understand that receiving high quality care – quickly and early – is the key to recovery.

The World Health Organization and the United Nations have urged countries to move “far beyond what sometimes appear to be frozen biomedical models” to a human rights-based, holistic, community health approach. There is compelling evidence to prioritise early community intervention, particularly for children so that they are as mentally healthy as they possibly can be.

Indeed, research also indicates that efforts to eradicate poverty and promote education are enhanced by improving mental health services. Add to this evidence of the strategic dilemma of the ever-expanding gap between supply and demand for all healthcare – including mental healthcare – and it is clear that we need to rapidly transition to integrated mental health systems, delivered early, in our local communities.

Ireland’s current mental health policy, ‘Sharing the Vision, A Mental Health Policy For Everyone’, recognises and sets a clear path to reframe mental health services. It includes actions to change societal understanding, challenge stigma, support recovery and enhance community inclusion. The policy sets a timeline to deliver this new approach by 2030. This determination and clear intent are to be welcomed, as is the fact that its full implementation was explicitly called out in the new programme for government.

Political will and ‘the moonshot’

Achieving this goal will come down to choices on the use of our human and financial resources over the next five years. We know that as a country we have the wealth, but we need to use it wisely – and in the public interest. This wealth could be described as our first-ever ‘moonshot’; that is, a chance to do something that we have not been in a position to do before. If this ‘moonshot’ is to be well directed, then there is nowhere better to aim it than at building modern and accessible community mental health services that will become our first port of call if we are unwell.

Recent research published by the European Commission showed that people in Ireland experienced the highest level of difficulty in accessing mental health services among citizens of 27 EU member states. For many, the only current route to accessing emergency mental health care is through our accident and emergency units in our general hospitals.

If this ‘moonshot’ is to succeed, we must first have the strength of our convictions to invest in additional community services, staffing and person-centred models of care which are inclusive, accessible and sustainable.

In mental health, we know that this means optimising newer community services over our historical bed-based system. However, we also need to ensure that these new services are integrated, with a ‘no wrong door’ approach. Access to services at national and regional levels should also be integrated so that patients, particularly parents, can be assured that their child is not pigeonholed into a particular service but instead receives targeted interventions based on their needs.

Second – and most critically – we now know that young people and marginalised groups, such as those with a mental illness, are not being helped early enough. Systematic, early and rapid intervention is key. Without this, we unintentionally condemn young people and their families to unnecessary mental distress.

Related Reads

Opinion: Proposed changes to the Mental Health Act must prioritise human rights

Psychiatrists: Changing the Mental Health Act will affect our ability to provide safe care

Health Minister warned of staff shortages by HSE in pre-Christmas message

Integration requires us to think bigger than the HSE as a provider of all services. Rather, it requires the mobilisation of all available resources across our economy and society. Regulation can help to ensure all services are of an appropriate standard — be that public, private or not-for-profit. This, in turn, can enhance mechanisms to deliver the Sláintecare universal healthcare objective that all people have access to all services based on need rather than their ability to pay.

Ireland has the capability to deliver mental health care rapidly and early, where the public, private and not-for-profit national and community organisations collaborate as part of an integrated system. This strengthening of collaboration is key to bridging the gap between supply and demand.

As the Dáil returns, I expect and hope that the building of integrated, accessible mental health services in our communities will form a key part of this new Government’s term in office. The next five years have the potential to shift our focus from short-term fixes to system-wide collaboration and innovation that current and future generations will thank us for.

John Farrelly is Chief Executive of the Mental Health Commission, the regulator for mental health services in Ireland.