This paper has been prepared to answer questions from HSE-MET on the number of specialists and Consultants that are required in Psychiatry in the next 5 and 10 years. It will address the policy documents and literature influencing these requirements. It will also address how mental health services are delivered into the future.
A Vision for Change (DOHC), accepted as government strategy for developing mental health services recommended setting up a workforce planning committee. It made recommendations around the number of staff required to deliver a community-based, evidence-based, and recovery focussed service. It specifically focussed on the need to deliver mental health services by Consultant-led specialist mental health teams. The number of Psychiatrists recommended was 430 Consultants and 380 Non Consultant Hospital Doctors. A persistent complaint about current mental health service is the lack of development of specialist teams, and the dissatisfaction of Service Users with seeing a different Registrar whenever they attend a clinic. (Vision for Change Implementation Group Report 2012; Annual Report MHC; Annual Report MHR, 2013). Following extensive consultation within the College of Psychiatrists of Ireland and review of the literature, this paper will recommend that we move to a mental health service with an adequate number of Consultants to both develop modern services, and be available to provide individual Consultant input for patients. We recommend that we move to a situation where we have 800 Consultants, and the number of psychiatric trainees required to meet future manpower planning needs for these 800 Consultants.
We are mindful of the fact that Irish mental health services have been consistently under resourced for the last ten years. Mental health problems account for 13% of the burden of disease (WHO, 2008) and yet in Ireland the budget for mental health in 2013 was 5.4% of the total health budget. There is evidence that for every £1 spent on mental health, there is a saving of £4 to the economy, (London School of Economics & Political Science, 2006) and it is based on this finding that the numbers of Consultant psychiatrists in the UK have been increased.