Ireland lacks key mental health services, report finds

A greater focus on community-based mental health services and measures to address stigma are among key proposals in a report published by TASC - the think-tank for action on social change.

The report, titled "Is an EU-wide approach to the Mental Health Crisis necessary?", examines and compares mental health services in Ireland, France and Poland.

Ireland is noted as the most affluent country in the study.

The research, in conjunction with the Brussels-based Foundation for European Progressive Studies, involved 33 interviews with representatives from the mental health sector, including doctors and psychiatrists or those working in advocacy and third sector organisations.

It also examined policy work already conducted by the European Commission and other organisations.

The study found that 42% of the population in Ireland met diagnostic requirements for at least one mental health disorder and more than one in ten adults had attempted suicide.

While it welcomed the recent development of online mental health and therapy delivery, it cautioned that it is "not a panacea for mental health services".

The report states that there is a lack of access to certain key services in Ireland "such as help for those experiencing a mental health crisis or emergency".

It also notes that spending on mental health is relatively low.

As a result of this, it points out that charities and local civil society organisations traditionally plug the gap but "often only receive ad-hoc or partial state funding".

It notes that Ireland's State services are "hospital-centric and there is a lack of primary mental health services".

In France, the incidence of depression doubled during the pandemic, with those in financial difficulty experiencing double or even triple the rate experienced by the rest of the population.

Rates of attempted suicide there are among the highest in Europe.

Compared to Ireland and Poland, there is relatively high investment in France.

However, the report notes that the dominance of hospital provision and the lack of community care leads patients with low level mental health conditions being admitted to acute psychiatric care unnecessarily.

Poland has a very low number of practising doctors, psychiatrists and nurses and is described in the report as being in a permanent state of crisis.

There is a particularly acute shortage of child psychiatrists and share of GDP and in per capita terms, health spending in Poland has remained consistently below the EU average.

The report has found that rates of anxiety and depression are higher among young people and increase with decreases in income.

Suicide remains much higher in Polish men compared to the EU average and mental and behavioural disorders account for the largest share (over 17%) of the benefits paid out by social insurance to those with short and long-term incapacity to work.

There are a number of recommendations in the report suggesting that EU member states address misconceptions, discrimination and stigma related to mental health.

This would include destigmatising language around mental health and moving away from the language of 'problems' because that suggests deficiency.

It suggests the promotion of public campaigns on mental health well-being and be clear that incidence and outcomes of mental health conditions cannot be improved without addressing the social determinants and inequalities of mental health.

It also suggests that member states be advised to conduct audits of current mental health provision before developing further strategies.

TASC has said the report’s proposals emphasise the need for a special focus on mental health services to vulnerable groups and those with specific needs in Ireland.

Director Shana Cohen said there is a need to address barriers in accessing the mental health system such as regional inequity of services and fear of stigma and discrimination.

She said: "Improving access will involve provision of primary and community-based provision.

"This is especially vital to promote prevention and early detection and to allow early intervention for mild to moderate psychological problems.

"Involving a wide range of stakeholders in the decision-making process and consulting people with lived experience and their representative organisations in all aspects of mental health strategy is necessary."