The outgoing Minister of State for Mental Health hadn't had much luck launching the Government's new mental health policy.
Every time Jim Daly planned to publish 'Sharing the Vision - A Mental Health Policy for Everyone' he faced an obstacle.
"I was hoping to do this last January, but when we were planning it the election was called so there was a pause, and then there was Covid".
The Cork South West TD, who announced his retirement from politics last year, thought about handing the launch over to his successor, but he decided against it.
"There was the danger that it would be opened up again and people might start reviewing it and eternally delaying it".
Few wanted to see the policy delayed - particularly service users who had input in to its creation.
People with 'lived experiences’, including parents who were having trouble getting their children seen by professionals, gave their views on how services could improve.
Chair of the oversight group Hugh Kane, whose job it was to see how Ireland’s previous mental health policy could be improved, travelled to town hall meetings.
"We tried to take a balanced view and draw out what we thought were the key things to make a difference".
"Primary and community level is where we need to develop because when people get into difficulty generally, it's not something really serious.
"If a person can speak to someone locally, that will very often resolve an issue. If it doesn't, then you can be moved to a professional councillor if required".
'Sharing the Vision' replaces Ireland’s previous mental health policy, which was launched in 2006.
'A Vision for Change' expired in 2016. Fourteen years ago it was viewed as a modern, progressive and ambitious policy. However, it failed due to a lack of full implementation.
This time around, an implementation monitoring group will be established by the next minister for mental health to ensure past mistakes are not repeated.
Mental Health Reform, which represents over 70-member organisations, says if the policy is properly resourced it could have a transformative impact on the mental health system.
Its CEO Fiona Coyle says a super junior minister for mental health is required to take political responsibility.
The Mental Health Commission says the next minister will be presented with the perfect opportunity to "finally and comprehensively implement person-centred, holistic, community mental health services."
Chairperson John Saunders has welcomed that the core principles of the previous policy have remained as a central plank of 'Sharing the Vision'.
The new policy focuses on promotion, prevention and early intervention, service access, co-ordination and continuity of care, social inclusion, accountability and continuous improvement.
It’s an ambitious list, given that it’s an uncosted policy document.
Hugh Kane of the oversight group believes there's a huge amount of "existing funding" that could be used to deliver outcomes.
It's not about how much is in the system or how much is being spent on the system", according to Minister Daly.
"It’s more about what are we achieving for mental health and what are we achieving through the money we are spending and the input we are putting in. So, it's about outcomes and recovery".
GPs who provide care for over 90% of patients with mental health conditions have cautiously welcomed the document.
"We need more face-to-face while maintaining the virtual, video and online solutions because it's really about providing as much choice to the population about how they want to access the types of supports that they need".
Assistant Medical Director of the Irish College of General Practitioners Dr Brian Osborne expressed the need for general practice to be supported in caring for these patients.
Among the suggestions are greater access to talk therapies including addiction services, improved integration with primary and secondary care and upscaling of digital technologies in mental health services in particular.
Covid-19 has pushed those digital technologies to the fore.
Clinical Adviser to National Office for Suicide Prevention at the Health Service Executive Dr Philip Dodd works in a clinic that is doing consultations and clinical assessments through video.
He points out that it provides a risk mitigation solution in the current climate.
"We need more face-to-face while maintaining the virtual, video and online solutions because it's really about providing as much choice to the population about how they want to access the types of supports that they need".
'Sharing the Vision' seeks to find solutions to problems around accessing Child and Adolescent Mental Health Services (CAMHS).
It proposes that the age range for CAMHS eligibility be increased to 25 from 18.
It’s believed that this will improve continuity of care and lead to better outcomes for service users because the transition from CAMHS to adult services is complex.
There’s also an emphasis on providing 24 hour, seven days a week supports for a small percentage of children.
It’s a big ask for a service that has growing waiting lists.
The Irish College of General Practitioners Medical Director Dr Tony Cox says the issues around long waiting times and difficulty accessing these services need to be addressed.
At yesterday’s launch, Dr Dodd said more support at primary care level would be developed under the new policy resulting in greater access to support allowing young people timely access.
"The most important thing in this document is emphasising is the need to develop resources at primary care level so children and young people can access supports in a quick and timely manner, so mental health needs don't escalate or be referred to specialist mental health services", he said.
The Psychiatric Nurses Association has described the policy as "a key test" for the incoming government.
General Secretary Peter Hughes says the PNA was not consulted by the 'A Vision for Change' review group regarding the new strategy.
And yet, he points out, frontline psychiatric nurses "will again be key in the delivery of crucial elements of the policy".
Mr Hughes has requested full engagement on the implementation of the policy which Mr Daly described yesterday as "substantial document" of which he is "very proud".
Now it’s up to his successor to ensure it is implemented successfully.
Read more:
New plan fails to address mental health staffing - IHCA
Mental health policy to be implemented 'in due course'
