'HSE cannot account for mental health spend'

The HSE cannot explain how its mental health budget is being spent because of major gaps in its accounting processes, according to a new report.

Fiona Crowley of Amnesty International, which commissioned the independent report, said it is alarming that there are such major gaps in the information we have on mental health expenditure.

"And even where the cash is accounted for, there are no mechanisms in place to measure how effectively it is being spent," she added.

Amnesty says this lack of financial accountability is astounding in view of the current economic climate.

The report has also found that the HSE continues to invest disproportionately in inpatient mental health treatment, with less than 20% of all staff in the service in community health teams.

This is despite the fact that community care has been Government policy since 1984 and is preferred by most service users and their families.

The report also indicates that at the current rate of progress, it could take up to 10 years to achieve the staffing levels recommended to develop mental health services in line with the Vision for Change report.

According to Fiona Crowley, it is simply not good enough to have a policy document that says the right things but does not deliver.

Key findings in the report include:

* Gaps in information needed to monitor funding and spending on mental health services

* Significant skill shortages  in community mental health services.

* Over-reliance on inpatient versus community care.

* Major delays likely in resourcing of Vision for Change.

* Expected 3.1% reduction in Government spending on mental health this year.

* Given the scale of expenditure involved on mental health, it is essential that resources are used effectively.

The report recommends that the targets in Vision for Change be reconfigured to realistic levels which take account of current constraints in public expenditure.

It says there is a need to reduce the dependency on inpatient care in mental health services.

[Posted: Mon 07/09/2009]