From Neglect

to Respect
A 10-point Agenda for Action
by the new
Irish Government
on Mental Health
June 2007
 “Mental health is central to the human,
social and economic capital of nations
and should therefore be considered as an
integral and essential part of other public
policy areas such as human rights, social
care, education and employment.

Therefore we, ministers responsible for

health, commit ourselves … to recognising The Irish Mental Health
the need for comprehensive Coalition comprises a Core
Group of five organisations
evidence-based mental health policies
that have combined forces
and to considering ways and means of and energies to advocate for
developing, implementing and reinforcing people’s rights to the highest
such policies in our countries.” attainable standard of mental
health and mental healthcare.

We demand that the new Irish

Government makes mental
health a priority.
Mental Health Declaration for Europe: Facing the Challenges,
Building Solutions
World Health Organization European Region
January 2005
Mental health is a human
right

Mental health is a human right, yet right help is available. If the new Irish
successive Irish governments have Government is committed to the
neglected mental health and related object and principle of human rights,
services. For example, children and it must make mental health a priority.
adolescents continue to wait years for
assessment, and they are placed in If the new national mental health
adult psychiatric hospitals in breach policy framework published by the
of the UN Convention on the Rights of Department of Health and Children in
the Child because children’s facilities January 2006, A Vision for Change,
are unavailable. There is widespread were implemented in full, it could
unavailability of alternatives to reverse many of the above human
medication, principally psychological rights concerns. It proposes
and social interventions, in breach of significant changes and
the right to the most appropriate and improvements in mental health
the least restrictive or intrusive services, and aims for a true
treatment. Ireland still has a high rate movement of services – the right
of hospitalisation for mental health services - into the community and
problems, due to limited community- people’s homes. It points to the
based services, conflicting with the importance of empowerment,
right to treatment in the least advocacy, peer support, offering a
restrictive environment. People with range of therapies, supporting
mental health problems can have carers, and, perhaps most
difficulty accessing or staying in importantly, recovery. It also
employment (the right to work is a recognises the crucial importance of
basic human right), or in education having service users centrally
(also a basic human right). involved in all planning and
decision-making, from official
At the extreme end, mental ill health processes to their individual cases,
can result in suicide or self-harm. For which is a fundamental human right.
others, particularly those with little It is not just a mental health services
support structures, they may become policy – it addresses a wide range of
homeless, or their behaviour may Government Departments and
bring them into contact with the agencies, which must take
criminal justice system, and many are responsibility for their role. We need
misdirected towards prison rather to see this policy translate into reality.
than appropriate mental healthcare Now is a critical time for action and
or support services. The vast majority commitment from the new Irish
of people with mental health Government.
problems continue about their lives
without encountering these
experiences, and for them, it is vital
that, when they need and want it, the
We demand that the new Irish Government,
which will span almost the entire lifetime of
A Vision for Change, commits to the following
actions at a minimum:

1. Full and Timely Implementation of A Vision for Change

Since the launch of A Vision for Change, there has been

little visible action, with the exception of the formation of an
Implementation Group, Independent Monitoring Group, and
Interim National Service User Executive. Given the wide
engagement by voluntary organisations and civil society in
the consultation undertaken in the development of A Vision
for Change, it is especially disappointing that so little
information on its implementation is available in the public
domain. The new Government must commit that it will
deliver and implement A Vision for Change, as a complete
plan by all Departments and agencies - in full, on time, and
with transparency.

2. A Comprehensive Implementation Plan for A Vision for

Change

According to the World Health Organization, mental health

policies can only be implemented through effective plans
and programmes. If it is not to remain aspirational, a
detailed implementation plan must be produced at the
earliest opportunity, setting out the major activities to
implement A Vision for Change, with explicit annualised
performance targets and indicators, timelines, and specific
resource commitments, across all relevant Government
Departments.

3. Implementing recommendations set out in progress

reports on implementation of A Vision for Change

The new Government must not only commit to producing full

and detailed annual progress reports, spanning all relevant
Departments and agencies, but also to implement swiftly the
recommendations set out in the reports. In May, the first
progress report was published by the Independent
Monitoring Group established by the Department of Health
and Children to overseeing implementation. It too pointed
out the central importance of an implementation plan,
clarifying divisions of responsibility, and ensuring that a
recovery orientation informs every aspect of service delivery.
It points to the many areas where implementation has been allocations across mental health catchment areas on the basis
slow, including in closing, and redeploying resources from, of equity. At present, there is a four-fold difference in resources
large psychiatric hospitals, and providing Child and available between services, with the least resourced having
Adolescent services and inpatient facilities. Its higher levels of socioeconomic deprivation. Considerations
recommendations must be implemented. such as the density of population, the socioeconomic status of
population and the existence of special needs such as
homelessness must be taken into account when deciding on
4. Interdepartmental Coordination on Mental Health mental health budgets. Proposals in A Vision for Change for
new or expanded services for vulnerable groups – e.g.
The Department of Health and Children is responsible for children, people with intellectual disabilities, people with eating
communication with relevant Departments and agencies disorders, forensic services – must be equitably resourced.
outside the health sector, but there is no concrete
interdepartmental working arrangement in evidence to
ensure cohesive and coordinated interagency action on the 7. Restructuring of Mental Health Services
recommendations made in A Vision for Change. There must
be targeted and specific interdepartmental coordination at Present government policy as outlined in A Vision for
government level to ensure the full implementation of A Change demands that all mental health services are
Vision for Change. This is also a recommendation from the restructured to ensure that they are person centred, user
Independent Monitoring Group, who have advised that friendly, responsive to need and recovery orientated. This
Government Departments should report through the demands changed working practices by all professional
interdepartmental group on a three monthly basis in staff; however, 17 months on, the essential framework for
relation to progress with the implementation of the implementing A Vision for Change is not yet in place.
recommendations for which they are responsible. Many
actions reported by Departments to the Independent
Monitoring Group were already in train before A Vision for 8. Adequate Resourcing of Suicide Prevention Strategies
Change, or are part of their existing commitments to people
with disabilities and do not make clear how people with Present government funding of Suicide Prevention Strategies
mental health problems will benefit specifically. is inadequate. Significant increases are required in the
resources allocated to the National Office for Suicide
Prevention, Health Service Executive and voluntary agencies
5. Prioritised Mental Health Expenditure engaged in suicide prevention. A minimum of €10 million
base budget per annum should be allocated to Suicide
The government needs to ensure that mental health is given Prevention Strategies.
an adequate and equitable share in Budget 2008. If mental
health is to achieve parity with other areas of health,
financial resources for mental health services should 9. Relocation of the Central Mental Hospital (CMH) from
progressively reach a minimum of 12% of revenue health proposed Thornton Hall site
spend, from the present 7.7%.
The last Government’s decision to move this hospital to a site
adjacent to the new prison site at Thornton Hall, North
6. Equitable Distribution of Financial Resources Dublin, must be reversed in favour of one that respects the
human rights of people with mental illness. To locate a
There is an urgent need for redistribution of financial therapeutic facility for people with mental illness - many of

From Neglect to Respect

whom who have not committed a crime - beside a prison is
stigmatising and discriminatory. Not alone has this
proposal been roundly rejected – by the families and carers
of current CMH residents, voluntary organisations, the
Mental Health Commission, the Clinical Director of the CMH,
and the Human Rights Commission – but it also flies in the
face of the core values and principles enshrined in A Vision
for Change.

10. Placing Ireland as a Leading Country in International

Action on Mental Health

There is growing international attention to mental health as

an issue that urgently needs to be addressed. At the 54th
World Health Assembly in Geneva in 2001, the world’s
health ministers conceded that mental healthcare has not
received “the level of visibility, commitment and resources
that is warranted by the magnitude of the mental health
burden”. In January 2005, the 52 Ministers of Health in the
WHO European Region, including Ireland, endorsed the
Helsinki Mental Health Declaration and Action Plan for
Europe. The Action Plan will serve to drive policy on mental
health promotion, prevention and treatment in the WHO
European Region until at least 2010, and sets out five
priorities and 12 areas for national action. The new Irish
Government should resolve to be at the fore of this charge,
not trailing behind. Ireland will appear before the UN
Committee on Economic, Social and Cultural Rights within
the next two years, and it should be with a record of
achievement on the right to mental health of which the Irish
people can be proud.
Final word
Almost every person in the country is
affected in some way by government
inattention to mental health, whether
directly or through the experience of
family or friends. While many people
with mental health problems will
never need mental health services or
supports, for those who do, the con-
sequences of timely and appropriate
services not being available can be
devastating. Action by the new Irish
Government on mental health promo-
tion, prevention and treatment could
dramatically reduce mental health
problems. The economic and social
benefit of action now will flow not
just to this generation, but to future
generations – while the cost of inac-
tion will be enormous.

Make mental health a

priority.
Irish Mental Health Coalition
Campaigning for improved mental health services

We call on the new Irish Government to

commit to:

1. Full and Timely Implementation of

A Vision for Change
2. A Comprehensive Implementation Plan for
A Vision for Change
3. Annual detailed progress reports on
implementation of A Vision for Change
4. Interdepartmental Coordination on
Mental Health
5. Prioritised Mental Health Expenditure
6. Equitable Distribution of Financial Resources IMHC Core Group Member
Organisations:
7. Restructuring of Mental Health Services • Amnesty International (Irish Section)
• Bodywhys – The Eating Disorders
8. Adequate Resourcing of Suicide Prevention • Association of Ireland
Strategies • GROW in Ireland
• Irish Advocacy Network
9. Relocation of the Central Mental Hospital from • Schizophrenia Ireland

proposed Thornton Hall site

10. Placing Ireland as a Leading Country in
International Action on Mental Health

C/O 38 Blessington Street,

Dublin 7
www. imhc.ie