Much of the focus during Mental Health Awareness Week is on what we as individuals can do to look after our own mental health. Yet while ordinary people are doing what they can,  this week we became aware of a very serious failing by government, in its duty to ensure our right to appropriate, good quality mental health care.

Thanks largely to the dogged determination of Mr. Paul Herbert, a full-time carer for his 35-year-old nephew Gareth Waterworth, and other families battling on behalf of their loved ones, the public were made aware of an astonishing gap in the oversight of mental health services here.

On 12 May, Mr. Herbert won a High Court battle that established that the RQIA, the regulatory body for health services, is legally required to scrutinise community-based mental health treatment. Mr. Herbert claimed that the RQIA had wrongly asserted it had no legal remit to regulate the provision of community mental health services. The background to this case is outlined here.

The challenge was due to be heard at the High Court next month, but the RQIA conceded it had been misdirected on a point of law. A senior judicial review judge made an order to quash its previous assertions.

In plain language, what this means is that the RQIA has admitted that since 2009, when the Mental Health Commission was stood down and the RQIA assumed responsibility, it did not know what its job was in relation to mental health services.

Image caption: Roberta Waterworth, Paul’s sister, who spearheaded the fight for Gareth’s care

Paul Herbert had previously outlined what that meant in practice for families like his:

“This failure means thousands of people and families, like Gareth and myself, unhappy about the level of mental health delivery, have nowhere to turn to for concerns to be investigated properly and acted on.”

“That in turn means that people in this sector end up with a second-class service. Our people are not lesser citizens.”

“The lack of RQIA inspection and regulatory oversight powers only serves to compound mental health stress issues and it’s the lives of people like my nephew, those without a voice, who need the most support.”

For many years now, families involved in #NewScript for Mental Health, alongside many others, have been ignored in their efforts to draw attention not only to the failures of mental health services, but also to the serious deficiencies in the oversight of these services.

It was left to families, some of whom had lost loved ones due to failures in services, others who were on their knees due to failure by the state to provide the care and support needed, to take on this fight.

From the Minister for Health, the Permanent Secretary, the Mental Health Champion’s Office, to the various health body CEOs and political parties – all of these individuals and organisations have been aware of this dereliction of duty in relation to mental health oversight. However, nothing was done to right this wrong. It was left to families, some of whom had lost loved ones due to failures in services, others who were on their knees due to failure by the state to provide the care and support needed, to take on this fight.

If a further reminder were needed as to the seriousness of these issues, this judgment comes as the Muckamore Abbey Inquiry continues to hear of the shocking failures of care and ill-treatment and abuse of vulnerable adults. Among the lines of inquiry is an examination of the regulatory framework to determine whether and if so, why, there were failures in the early identification, investigation and resolution of issues raised with the treatment of patients.

Understandably, many families will be looking at this judgment and asking whether the failures they experienced at the hands of services, some with devastating consequences, might not have happened if the proper oversight had been in place.

Image caption: Families and the public need to hear from the RQIA, the Department of Health, Health Trusts, the Mental Health Champion’s Office and political parties as to how they all intend to right this wrong.

Families deserve answers as to how this was allowed to prevail for well over a decade. They need to know who will now take responsibility. They need a full independent review to be carried out, one that results in learning for RQIA and other relevant bodies. There are wider issues in relation to the failures in accountability that must also be examined.

This court declaration raises many serious questions that now need answers.

What steps will the Department for Health and the RQIA take to respond to the Court Declaration in relation to community mental health services?

The court declaration dealt solely with community mental health services. Does the RQIA regulate in-patient mental health services? If so, what powers does it have and how are these powers being utilised?

If RQIA does not currently regulate in-patient mental health services, or there are identified gaps in the regulatory framework, what steps will RQIA and the Department of Health take to rectify these issues?

What steps will the Department for Health and the RQIA take to re-build the lost trust and confidence among mental health service users and their families?

Swift action must now follow awareness. Families and the public need to hear from the RQIA, the Department of Health, Health Trusts, the Mental Health Champion’s Office and political parties as to how they all intend to right this wrong. Staying silent in the face of awareness and knowledge of this serious human rights failing is no longer an option. Not during Mental Health Awareness Week. Or any week from here on.