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Mental Health Policy in Ireland 1984–2004: theory, overview and future directions

Published online by Cambridge University Press:  13 June 2014

Brendan D Kelly*
Affiliation:
National Forensic Psychiatry Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland

Extract

Recent years have seen renewed emphasis on the importance of mental health policy as a key component of health and social policy at both national and international levels. In 2001 the European Commission produced a public health framework for mental health in the EU. In the same year, the World Health Organisation devoted its annual health report to mental health and called on countries to formulate, update and implement mental health policies. The EU and WHO initiatives both recognised that the challenges facing mental health policy makers are increasingly transnational in scope, related to issues such as rapid demographic change, increased transnational migration, the protection of human rights and the implementation of a growing number of international laws, directives and protocols in relation to mental health care.

Significant progress has been made in the development of Irish mental health services over the past 40 years. Nevertheless, many challenges remain. The aims of this paper are to outline:

• Prevailing theoretical perspectives on mental health policy

• Mental health policy in Ireland since the last major policy revision in 1984

• Relevant economic and demographic changes in Ireland since 1984

• Relevant clinical, legislative and policy developments in relation to mental health

• Future directions for mental health policy.

Electronic literature searches were performed using Psyclit (American Psychological Association, 1887–2003), Medline (United States National Library of Medicine, 1985 – 2003), with broad search terms related to mental health policy. Additional books and papers were identified by tracking back through references and consulting with colleagues. Policy documents and selected literature on Irish psychiatric services were reviewed and related to recent literature on mental health policy.

Type
Reviews
Copyright
Copyright © Cambridge University Press 2004

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References

1.Jenkins, R. Supporting governments to adapt mental health policies. World Psychiatry 2003; 2: 1419.Google Scholar
2.Lavikainen, J, Lahtinen, E, Lahtinen, V. Public Health Approach On Mental Health in Europe. Helsinki: Stakes, Helsinki, 2001.Google Scholar
3.WHO. The World Health Report 2001. Mental Health: New Understanding, New Hope. WHO. Geneva, 2001.Google Scholar
4.Department of Health. The Psychiatric Services – Planning For The Future. The Stationery Office, Dublin, 1984.Google Scholar
5.Rogers, A, Pilgrim, D. Mental Health Policy in Britain (2nd ed.). Palgrave, Hampshire, 2001.CrossRefGoogle Scholar
6.Bryson, JM. Strategic Planning for Public and Non-Profit Organisations. Jossey-Bass, San Francisco, 1995.Google Scholar
7.Jenkins, R, McCulloch, , Friedli, L, Parker, C. Developing A National Mental Health Policy (Maudsley Monographs 43). Psychology Press, United Kingdom, 2002.Google Scholar
8.United Nations. Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care. United Nations, Secretariat Centre For Human Rights, New York, 1991.Google Scholar
9.Institute of Medicine. Neurological, Psychiatric And Developmental Disorders: Meeting The Challenge In The Developing World. National Academy Press, Washington, 2001.Google Scholar
10.Harding, TW. Human rights law in the field of mental health: a critical review. Acta Psychiatr Scand (Supp), 2000; 399: 2430.CrossRefGoogle Scholar
11Central Statistics Office. Statistical Yearbook of Ireland. The Stationery Office, Dublin, 2003.Google Scholar
12.Economist. Europe in Figures. The Economist, London, 2001.Google Scholar
13.Organisation for Economic Cooperation and Development. OECD Economic Surveys 1996–97 Ireland 1997. Organisation for Economic Cooperation and Development, Paris, 1997.Google Scholar
14.O' Sullivan, T, Butler, M. Current Issues In Irish Health Management: A Comparative Review. The Institute of Public Administration, Dublin, 2002.Google Scholar
15.Daly, A, Walsh, D. Activities of Irish Psychiatric Services 2001. The Health Research Board, Dublin, 2002.Google Scholar
16.Department of Finance. National Development Plan. The Stationery Office, Dublin, 1999.Google Scholar
17.O'Connell, P. Astonishing Success: Economic Growth And The Labour Market In Ireland (International Labour Organisation Employment And Training Paper No. 44). International Labour Organisation, Geneva, 1999.Google Scholar
18O'Toole, F. After The Ball. Tasc, Dublin, 2003.Google Scholar
19.Economist. Globalisation. Economist/Profile, London, 2001.Google Scholar
20.Stiglitz, J. Globalization and its discontents. Penguin, London, 2002.Google Scholar
21.Kelly, BD. Globalisation and psychiatry. Adv Psychiatr Tr 2003; 9:464474.CrossRefGoogle Scholar
22.MacÉinrí, P. Immigration into Ireland: Trends, Policy, Responses, Outlook. Irish Centre For Migration Studies, Cork, 2001. (available at www.migration.ucc.ie).Google Scholar
23.Gleize, L, Laudon, F, Sun, LYet al (2000) Cancer registry of French Polynesia: results for the 1990–1995 period among native and immigrant population. Eur J Epid 2000; 16: 661667.CrossRefGoogle Scholar
24.Singh, GK, Siahpush, M. All-cause and cause-specific mortality of immigrants and native born in the United States. Am J Pub Health 2001; 91:392399.Google ScholarPubMed
25.Gavin, B, Kelly, BD, Lane, Aet al.The Mental Health of Migrants. Ir Med J 2001; 94: 229230.Google ScholarPubMed
26.Nazroo, J. Ethnicity And Mental Health. PSI, London, 1997.Google Scholar
27.Bhugra, D, Jones, P. Migration and Mental Illness. Advances in Psychiatric Treatment 2001; 7, 216223.CrossRefGoogle Scholar
28.Lavik, NJ, Hauff, E, Skrondal, Aet al.Mental disorder among refugees and the impact of persecution and exile: some findings from an out-patient population. Br J Psychiatry 1996; 169: 726732.CrossRefGoogle ScholarPubMed
29.Harrison, G. Searching for the causes of schizophrenia: the role of migration studies. Schizophr Bull 1990; 16: 663671.CrossRefGoogle Scholar
30.Selten, JP, Slaets, JP, Kahn, RS. Schizophrenia in Surinamese and Dutch Antillean immigrants to The Netherlands: evidence of an increased incidence. Psychol Med 1997; 27:807811.CrossRefGoogle Scholar
31.Feeney, L, Kelly, BD, Whitty, Pet al (2002) Mental illness in migrants: diagnostic and therapeutic challenges. Ir J Psychol Med 2002; 19; 2931.CrossRefGoogle ScholarPubMed
32.Hutchinson, G, Takei, N, Bhugra, Det al.Increased rate of psychosis among African-Caribbeans in Britain is not due to an excess of pregnancy and birth complications. Br J Psychiatry 1997; 171:145147.CrossRefGoogle ScholarPubMed
33.Department of Health and Children. Long-stay Activity Statistics. The Stationery Office, Dublin, 2001.Google Scholar
34.Swanwick, G, Lawlor, B. Services For Dementia Sufferers And Their Carers: Implications For Future Development. In: The Irish Health System In The 21st Century (eds A.L, Leahy & M.M., Wiley). Oak Tree Press, Dublin, 1998.Google Scholar
35.Comas-Herrera, A., Wittenberg, R., Pickard, L., et al.Cognitive impairment in older people: its implications for future demand for services and costs. PSSRU Discussion Paper 1728. Personal Social Sciences Research Unit, London School of Economics, London, 2003.Google Scholar
36.Weissman, MM, Leaf, DJ, Tischler, GLet al.Affective Disorders in Five United States Communities. Psychol Med 1988; 18:141153.CrossRefGoogle ScholarPubMed
37.Johnson, J, Weissman, M, Klerman, GL. Service utilization and social morbidity associated with depressive symptoms in the community. J Am Med Assoc 1992; 267:14781483.CrossRefGoogle ScholarPubMed
38.O' Neill, C, O' Connell, H, Lawlor, B. Psychiatric consultation to elderly medical inpatients in a general hospital. Ir J Psych Med 2003; 20:8083.CrossRefGoogle ScholarPubMed
39.Greene, E, Bruce, I, Cunningham, C, Coakley, D, Lawlor, B. Self-reported alcohol consumption in the Irish community dwelling elderly. Ir J Psych Med 2003; 20: 7779CrossRefGoogle ScholarPubMed
40.Department of Health and Children. The Years Ahead: A Policy For The Elderly (Report Of The Working Party On Services For The Elderly). The Stationery Office, Dublin, 1998.Google Scholar
41.Mental Health Commission. Annual Report 2002. The Mental Health Commission, Dublin, 2003.Google Scholar
42.Keogh, F, Roche, A, Walsh, D. “We Have No Beds…”: An Enquiry Into The Availability and Use of Acute Psychiatric Beds In the Eastern Health Board Region. The Health Research Board, 1999.Google Scholar
43.Irish Psychiatric Association. The Stark Facts. The Irish Psychiatric Association, Dublin, 2003.Google Scholar
44.Irish College of Psychiatrists Position Statement On Psychiatric Services For Adolescents. Irish College of Psychiatrists, Dublin, 2002.Google Scholar
45.O' Neill, C, Sinclair, H, Kelly, Aet al.Interaction of forensic and general psychiatric services in Ireland: learning the lessons or repeating the mistakes? Ir J Psychol Med 2002; 19: 4854.CrossRefGoogle ScholarPubMed
46Linehan, S, Duffy, D, O' Neill, H, O' Neill, C, Kennedy, HG. Irish Travellers and forensic mental health. Ir J Psychol Med 2002 19: 7679.CrossRefGoogle ScholarPubMed
47.McKeon, K. Mentally III And Homeless In Ireland: Facing The Reality, Finding Solutions. Disability Federation of Ireland. Dublin, 1999.Google Scholar
48.Amnesty International. Mental Illness: The Neglected Quarter. Amnesty International, Dublin, 2003.Google Scholar
49.Department of Health and Children. The Mental Health Act 2001. The Stationery Office, Dublin, 2001.Google Scholar
50.Mills, S. Clinical Practice And The Law. Butterworths, Dublin 2002.Google Scholar
51.Turner, TH. Why do so few patients appeal against detention under section 2 of the Mental Health Act? New Zealand's system has much to offer. BMJ 1995; 310:11961197.CrossRefGoogle ScholarPubMed
52.Kelly, BD. The Mental Health Act 2001. Ir Med J 2001; 95:151152.Google Scholar
53. Royal College of Psychiatrists (Irish Division) Comments on the Mental Health Act 2001. Royal College of Psychiatrists (Irish Division), Dublin, 2001.Google Scholar
54.Department of Justice, Equality and Law Reform. The Criminal Law (Insanity) Bill. The Stationery Office, Dublin, 2002.Google Scholar
55.Department of Justice, Equality and Law Reform. The Disability Bill. The Stationery Office, Dublin, 2001.Google Scholar
56.Irish Times. Editorial: Disability Bill. December 22nd 2001.Google Scholar
57.Humphreys, J. Calls to withdraw the Disability Bill rejected. Irish Times, 11th February 2002.Google Scholar
58.People With Disabilities in Ireland. Disabilities Bill must be rights-based and all-embracing. Cumhacht Newsletter. Vol. 1, No. 6; Autumn 2003.Google Scholar
59.Department of Health. Shaping A Healthier Future: A Strategy For Effective Healthcare In The 1990s. The Stationery Office, Dublin, 1987.Google Scholar
60.Department of Health and Children. Quality and Fairness: A Health System For You. The Stationery Office, Dublin, 2001.Google Scholar
61.Department of Health and Children. Report Of The National Task Force On Suicide. The Stationery Office, Dublin, 1998.Google Scholar
62.Department of Health and Children. Strategic Task Force on Alcohol: Interim Report. The Stationery Office, Dublin, 1998.Google Scholar
63.Cassidy, B. Strategy Has Done Little For Psychiatry. Irish Medical Times, March 14th 2003.Google Scholar
64.Gabbard, GO, Kay, J. The fate of integrated treatment: whatever happened to the biopsychosocial psychiatrist? Am J Psychiatry 2001; 158:19561963.CrossRefGoogle Scholar
65.Department of Health and Children. Guidelines on Good Practice And Quality Assurance In Mental Health Services. The Stationery Office, Dublin, 1998.Google Scholar
66.Department of Health and Children. Report of the Inspector of Mental Hospitals For The Year Ending 31 st December 2001. The Stationery Office, Dublin, 2002.Google Scholar
67.Department of Health and Children. Making knowledge Work For Health. The Stationery Office, Dublin, 2001.Google Scholar
68.Prospectus. Audit of Structures and Functions in the Health System. The Stationery Office, Dublin, 2003.Google Scholar
69.Commission on Financial Management and Control Systems in the Health Service. Report of the Commission on Financial Management and Control Systems in the Health Service. The Stationery Office, Dublin, 2003.Google Scholar
70.National Task Force on Medical Staffing. Report of the National Task Force on Medical Staffing. The Stationery Office, Dublin, 2003.Google Scholar
71.Shannon, J. Hanly will need doubling of students. Medicine Weekly, 3rd December 2003.Google Scholar
72.West, P. Hanly and NHS report and not incompatible. Irish Medical Times, 5th December 2003.Google Scholar
73.McGuinness, I. Major discrepancy in Hanly. Irish Medical Times, 5th December 2003.Google Scholar
74.Hanly, Ryan S.‘a Dublin 4 solution.’Irish Medical Times, 5th December 2003.Google Scholar
75.Hunter, N. ‘Benefits of Hanly must be sold more vigorously to the public’Irish Medical News, 1st December, 2003.Google Scholar
76.Bergin, D. IHCA concern at no Hanly input into Health Service Executive. Irish Medical News, 1st December 2003.Google Scholar
77.Medicine Weekly. Editorial: Hanly Heckles. Medicine Weekly, 3rd December 2003.Google Scholar
78.Wren, MA. Unhealthy State: Anatomy of a Sick Society. New Island, Dublin, 2003.Google Scholar
79.Beesley, A. Group set up to prepare new policy on mental health. Irish Times, 5th August 2003.Google Scholar
80.Sackett, DL, Rosenberg, WMC, Muir Gray, JAet al.Evidence based medicine: what it is and what it isn't. BMJ 1996; 312: 7172.CrossRefGoogle ScholarPubMed
81.McCauley, M, Rooney, S, Clarke, C, Carey, T, Owens, J. Home-based treatment in Monaghan: the first two years. Ir J Psychol Med 2003; 20: 1114.CrossRefGoogle ScholarPubMed
82.Jenkins, R. Making psychiatric epidemiology useful: the contribution of epidemiology to government policy. Acta Psychiatr Scand 2001; 103: 214.CrossRefGoogle ScholarPubMed
83.Barry, J. Developments In The Epdiemiology Of Disease In The Next Century. In: The Irish Health System In The 21st Century (eds A.L., Leahy & M.M., Wiley). Oak Tree Press, Dublin, 1998.Google Scholar
84.Clarke, M, O'Caflaghan, E. Is earlier better? At the beginning of schizophrenia: timing and opportunities for early intervention. Psychiatr Clin North Am 2003; 16, 6583.CrossRefGoogle Scholar
85.Department of Health and Social Security. Royal Commission On The Law Relating To Mental Illness And Mental Deficiency. Cmnd 169. London: Her Majesty's Stationery Office, London, 1957.Google Scholar
86.George, SL, Shanks, NJ, Westlake, L. Census of Single Homeless People in Sheffield. BMJ 1991;302:13871389.CrossRefGoogle ScholarPubMed
87.Holohan, TW, Holohan, W. Health and Homelessness in Dublin. Ir Med J 2000; 93: 4143.Google ScholarPubMed
88.Lewis, G, Araya, R. Globalization and mental health. In: Psychiatry in Society (eds. Sartorius, N, Gaebel, W, Lopez-Ibor, JJ, Maj, M) Wiley, Chichester, 2002.Google Scholar