DEINSTITUTIONALISATION IN THE MENTAL HEALTH SYSTEM:

HOW FAR HAVE WE COME?

Focus Ireland Policy Conference

25th September 2014

Shari McDaid, Director

Our goal is for an Ireland where people with mental health difficulties can recover their well-being and

live a full life in their community.

UNITE – INFORM - ADVOCATE

RECOVERY = SOCIAL INCLUSION

Recovery is not just about becoming well - it’s about recovering your life.

€

RECOVERY = SOCIAL INCLUSION

“personal responsibility must be matched with social responsibility.”

Mary O’Hagan, Survivor Activist

MHR ADVOCATING FOR HOUSING SUPPORTS

National Disability Strategy Stakeholders Group Housing Strategy for People with Disabilities sub-

group on mental health MHR’s Homeless Sector Advisory Group Pre-budget submissions

Tenancy sustainment support Designated places for people transitioning from

HSE mental health service accommodation Protecting rent supplement

DEINSTITUTIONALISATION IN IRELAND

Year Number of inpatients

1956 21,720

1966 18,084

1976 14,473

1986 11,643

1996 5,212

2002 3,891

2006 3,389

2013 2,401

adapted from Health Research Board: Irish Psychiatric Units and Hospitals Census 2013 Bulletin

Inpatients in Irish psychiatric units and hospitals 1956-2013

WHERE DID PEOPLE WITH ENDURING MENTAL HEALTH DIFFICULTIES GO?

2,790 beds in HSE high, medium and low support accommodation in 2011

Rise in prison population 2.6% of sentenced prisons with severe/enduring

mental disorder 7.6% of remand prisoners Ireland commits over 300 people to prison each

year w/ six month prevalence of severe/enduring mental disorder

66% of homeless service users in Cork Simon Community have a mental health difficulty

Living with parents? Living in isolation in the community?

CURRENT ISSUES

Impact of the wider housing crisis Difficulties discharging people from inpatient

units Lack of appropriate accommodation Discharged into homeless hostels

Gaps in mental health support within homeless services Lack of in-house or on-tap mental health

expertise Difficulties accessing support in a crisis Difficulties accessing support for people with a

dual diagnosis (mental health and addiction)

POLICY ON HOUSING FOR PEOPLE WITH MENTAL HEALTH DIFFICULTIES

A Vision for Change Little to say Equal right to housing Housing for people with mental health difficulties

should be the responsibility of local authorities

HOUSING STRATEGY FOR PEOPLE WITH A DISABILITY 2011-2016

Strategic Aim 5:

“To address the specific housing needs of people with a mental health disability, including through the development of frameworks to facilitate housing in the community, for people with low and medium support needs moving from mental health facilities, in line with good practice.”

HOUSING STRATEGY FOR PEOPLE WITH A DISABILITY 2011-2016

Commitments:• Local authorities to include pwmhd in housing

plans• Framework for transition from HSE

accommodation to appropriate community settings

• Identify a funding stream for accommodation needs

• Examine potential for transfer of low and medium support residences to local authorities/VHAs

• Ensure HSE provides mental health supports• Examine potential of tapered, ‘Housing First’

supports

HOUSING STRATEGY FOR PEOPLE WITH A DISABILITY 2011-2016

Commitments (cont’d):• Guidance for local authorities and VHAs• National data system for homeless services• Effective discharge plans for people leaving

residential, acute or prison settings• Support befriending services• Mental health awareness training for local

authority staff• Etc.

ON MHR’S CURRENT PRE-BUDGET CAMPAIGN Campaign for €50m investment in community-based

mental health services and 24/7 crisis supports.

Target: 20,000 signatures. So far: 13,000. www.mentalhealthreform.ie/petition2014 #MentalHealthLifeSaver

www.mentalhealthreform.ie

Twitter - @MHReform

www.facebook.com/mentalhealthreform

Email: info@mentalhealthreform.ie

Tel: 01 874 9468

Coleraine House, Coleraine St., Dublin 7