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 subgroup 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
Inpatients in Irish psychiatric units and hospitals
1956-2013
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
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