Green Party Mental Health Manifesto #GE2020

In the third of this series of blogs analyzing the pre-election manifesto’s on mental health of each of the main political parties, next up we have the Green Party

The first observation is that unlike both Sinn Fein and Fianna Fail, the Green Party have not released a stand alone Mental Health manifesto but have incorporated into the main body of their overall manifesto.

To protect and promote mental health in Ireland, we will:

Improve access to the appropriate level of mental health care in a timely manner and institute clear referral pathways across and between services.

You can only improve access to a service if that service currently exists or has the capacity within it to be readily accessible to the communities needs. What does timely manner mean, people who need mental health services need to be realistically communicated to in relation to if they seek help how long will they wait. Due to decades of under funding we know that currently the length of time waiting is intolerable. Clear referral pathways already exist but again there is little point in being clear where / how to be referred if there is no certainty that you will be seen in a time frame that is meaningful to you. We do need clearer shared care protocols between services that work for the people and have clear and equitable reporting relationships and governance structures with the person accessing both services always at the centre of it.

To make the most of available resources, we will ensure that mental health services provided by non-governmental organisations, such as Pieta House and Jigsaw, are integrated with a system of care that includes local statutory and community services

Interesting proposal, clarifying reporting relationships, responsibilities, models of care is a likely minefield and could take years of negotiations to work out. Coordinating and integrating care is a good idea in theory but the logistics of it are a long shot I think

Support the provision of ‘safe spaces’, which help people to access support locally in places
not normally associated with mental health provision, including community spaces, sporting
facilities and facilities for mental health services

Creating additional community spaces that make people feel less isolated, alone, give them a sense of community and belonging, get them out of the house and busy and active is positive for mental health and well being, needs more detail of how this would be achieved and funding to make it happen

Review and amend the Mental Health Act, 2001, which currently does not grant young
people, aged 16-17 years old, the right to consent to treatment for their mental health.
For many years, people aged 16-17 years old have had the right to consent to treatment
for their physical health, but not their mental health. This situation is seriously out of
compliance with international human rights standards.

Delighted to see this included in the Green Party manifesto and it’s long overdue. Mental health is health so there should be no disparties in your rights to seek treatment in physical vs mental health. We have a situation at the moment where a 16 or 17 year old has the right to consent to a referral to mental health services but cannot give consent for treatment. It’s a bizarre situation that needs to be urgently rectified so that young people’s mental health rights are brought on par with physical health rights.

Ensure that there is an adequate geographical coverage of mental health services, particularly
supports relating to suicide and crisis.

We do need to put specific measures in place to address the post-code lottery for accessing mental health services. Difficulties in recruitment of staff to specific geographical areas of the country are well known. What I don’t see here is how the Green Party would ensure this geographic spread?

Support the implementation of full Community Mental Health Teams, as outlined in A Vision for
Change, and an improvement in the manner in which these services can be accessed and exited
seamlessly.

Most of the political parties reference A Vision for Change but few note that it is 14 years old or that there is A Vision for Change refresh awaiting publication for the last number of months so we still don’t know what new Vision will be proposed. In addition we need to stop talking about community mental health teams as a whole or how many there are because it disguises significant gaps across disciplines. If we look at the HSE Work Force Planning report we can see at a glance across the country which disciplines are under resourced and to what degree so that then plans can be made which are discipline specific and needs / skills led.

Continue to recognise the importance of a variety of ‘talk therapies’ in helping to relieve
distress and address challenges in our lives. We also believe that providers of these services, psychotherapists, counsellors and psychologists should be regulated by an independent body
(similar to the Teaching Council) attached to the Dept. of Health.

This section starts off really well, noting the importance of talk therapies as one of the range of mental health supports that should be available across the continuum of mental health provision. Then things go a little downhill. What I’m wondering is how the Green Party have not heard of Coru the independent statutory body set up to regulate health and social care practitioners. Statutory registration for Psychologists has not yet been enacted (it needs to be) and as I understand it exploratory discussions have begun re the need to bring Counsellors and Psychotherapists under Coru also, a new body is therefore not needed.

Recommend the appointment of a School Mental Health Officer to ‘mental health proof’
the culture of every secondary school so that all staff feel confident to teach children with
mental health needs in a supportive way and know clearly how and where to refer those
who may be in crisis.

What would be the professional background or training of a School Mental Health Officer? What supervision supports would be put in place for these officers as there is / should be for other mental health workers? Currently teachers / schools cannot refer to services such as CAMHS under current guidelines but can recommend a GP review. Operational guidelines would need to be updated / amended if this new role was to provide such a service. Needs a lot more clarity and definition about the role and how it would work before it’s potential efficacy could be fully considered.

Implement cost effective prevention and intervention measures. The earliest form of
intervention for young people is intervention at the level of support for parents, guardians
and carers. This support should extend from the prenatal period right through the period
of youth. Help for parents should begin from pregnancy and families should be supported
throughout their journey. We propose to resource the provision of early childhood and
family interventions for families experiencing parenting difficulties.

This is the first manifesto I’ve reviewed that (rightly) identifies how important is for children and young people to support their parents and the first to mention prenatal care. Parenting can be difficult at the best of time, even more so if your child happens to experience mental health difficulties, there’s no manual of what’s the best thing to do, it creates self-doubt and anxiety in parents, the need help. They are also the earliest and best form of support for young people because they can support that young person at 9pm on a Friday night when they’re struggling at home. I’d be interested to know what the Green Party believe are cost effective measures and what the evidence base is behind what they’re thinking of. Resourcing can take many levels, psycho-education campaigns, literature, groups, drop-in advice clinics all the way up to individual support to parents or family therapy. A full range of supports needs to be available to parents. This won’t come cheap but it’s benefit to kids is invaluable. Without specific proposals of what this might look like it’s difficult to evaluate but the principle of it is certainly one I’d support

Consider the needs of new parents who may develop mental health issues in the delivery of
pre- and post-natal services.

Similar to above, positive and welcomed that the needs of parents pre and post-natal is being recognised. Consider the needs is a little vague and requires more concrete plans

Roll out a national e-Mental Health strategy to further develop online services that provide
a positive framework of activity for people between visits to their healthcare professionals.

Is this a psycho-education strategy with content for people to guide them post sessions or is it intended to be reminders of specific strategies learned in sessions. Has positive potential but again needs more detail of what this strategy might look like and who it’s aimed at.

Encourage and promote investment in mental health research to help us to identify what
prevents mental health difficulties from becoming entrenched and what improves
outcomes.

I would certainly support more investment in mental health research in Ireland that looks specifically at what improves outcomes. In any mental health service we need to focus more on what are the outcomes for those who avail of a service. It’s not enough to measure how accessible a service is but arguably more important to know if the service assisted the person to achieve the outcomes they hoped for.

Verdict

There are a number of positive aspirations in the Green Party mental health chapter of their overall manifesto. Quite a few are lacking in detail of how they might be operationalised. Similar criticism to the Sinn Fein mental health manifesto that there are no clear budgetary commitments of how much funding would be required or allocated to make these proposals a reality. The lack of recognition or understanding of the statutory role of Coru and it’s relevance to the regulation of Psychologists when it is fully enacted for Psychologists. It did make some reference to needing to be mindful of the needs of pre and post-natal care for parents but again without any sense of what that might look like. This has been the only manifesto so far to mention funding research in mental health which is a plus.