Mental health services for people with intellectual disability in Ireland: evidence, barriers and opportunities
| DOI | https://doi.org/10.1108/AMHID-03-2018-0016 |
| Date | 02 July 2018 |
| Pages | 105-113 |
| Published date | 02 July 2018 |
| Author | Hugh Ramsay,Philip Dodd |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Mental health services for people with
intellectual disability in Ireland: evidence,
barriers and opportunities
Hugh Ramsay and Philip Dodd
Abstract
Purpose –The purpose of this paper is to outline the historical background and policy context of mental
health services for people with intellectual disability (ID) in Ireland. It then considers recent implementation and
lessons from the Irish experience.
Design/methodology/approach –The policy background and research literature relevant to the
development of mental health services for people with ID in Ireland was reviewed and discussed.
Findings –Mental health services in Ireland remain in a state of change, moving towards the implementation
of specialist multi-disciplinary teams in the community, alongside previous models of care and service.
Research limitations/implications –This paper summarises recent advances and research regarding
mental health services for people with ID in Ireland.
Practical implications –The paper illustrates the process of delivering changes to mental health services
with practical implications for mental health services internationally.
Originality/value –This is the first paper in many years to summarise the development of mental health
services for people with ID in Ireland. There has been considerable recent change and it is therefore important
to provide a useful reference for the current status of services.
Keywords Service development, Community services, A Vision for Change, Change implementation,
Mental health of intellectual disability, Mental health policy
Paper type General review
Background
It is well recognisedthat people with an intellectual disability (ID) have higher ratesof mental illness
and psychological distress than the general population (Cooper et al.,2007).InIreland,itis
estimated that 26 per cent the general adult population (over 15 years) experience psychological
distress at anygiven time (Central Statistics Office,2015), while 47.5 per cent of adults with ID over
40 years in Irelandhad emotional, nervousor psychiatric conditions( McCarronet al.,2011).Those
with ID and mental healthdifficulties are more likely to be women, olderin age and have severe or
profound ID, comparedto those with ID without mental health difficulties (McCarron et al.,2011).
The Republic of Ireland is a small, wealthy, member-state of the European Union (EU), with a
population of 4.76million (CSO, 2016) and a gross domestic product per capita of $72,632 (IMF,
2017). Total health spending in Ireland was €3,939 per head in 2015, higher than in most EU
countries, with about 70 per cent of this spending was public spending, coming from general
taxation (OECD/European Observatory on Health Systems and Policies, 2017). Due to gaps and
limitations in public benefits, about 44 per cent of the population have private health insurance
and these spending amounts to about 12 per cent of health spending. The Department of Health
provides strategic leadership to public health services and allocates a budget, primarily to the
Health Service Executive (HSE), which has operational responsibility for care provision in public
hospitals, community health services and social care services (OECD/European Observatory on
Health Systems and Policies, 2017). Public health services are provided by the HSE and by
Received 30 March 2018
Revised 29 May 2018
Accepted 2 August 2018
Hugh Ramsay is Consultant
Psychiatrist at the Department
of Psychiatry, St Michael’s
House, Dublin, Ireland; and is at
the Royal College of Surgeons
in Ireland, Dublin, Ireland.
Philip Dodd is based at the
Psychiatry Department,
St Michael’s House,
Dublin, Ireland.
DOI 10.1108/AMHID-03-2018-0016 VOL. 12 NO. 3/4 2018, pp.105-113, © Emerald Publishing Limited, ISSN 2044-1282
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
PAGE105
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