Continuing resource concerns over Sharing the Vision roll-out

While progress has been made in implementing the Government’s Sharing the Vision (StV) mental health policy, concerns remain around resourcing, as well as recruitment and retention.

Those monitoring the policy’s roll-out have also raised questions about the impact of the HSE’s ongoing regionalisation process.

StV is Ireland’s 10-year (2020–2030) national mental health policy, aimed at enhancing mental health services and supports. In April, the Government launched the next implementation plan for the strategy, which covers 2025 to 2027.

The plan includes several key commitments: The publication of a national model of care for child and youth mental health services; increased capacity for counselling in primary care; and the development of a “clear path” to universal access to counselling.

The national implementation and monitoring committee (NIMC) is responsible for driving and overseeing the policy’s implementation.

According to minutes from the NIMC steering committee meeting in May, members discussed a new StV policy implementation progress report ahead of its publication.

Mr Derek Chambers, the HSE’s Mental Health Policy Implementation Lead, told the meeting that this was both the first report of the year and the first produced under the new StV implementation plan.

He said recent changes to the report’s structure – introduced following last year’s review of the NIMC – had allowed for more qualitative data collection. The latest update on StV recommendations showed 56 on track, 21 facing minor delivery issues, 20 marked as complete and considered ‘business as usual’, and four experiencing major delivery issues.

According to the report, these major issues included the roll-out of early intervention in psychosis across the health service. Another is the intensive care rehabilitation unit in Portrane, Co Dublin, which has yet to open “due to lack of staffing”. A business case for the unit is currently being developed.

Also, the report noted the current national safeguarding policy does not incorporate mental health services. But work is ongoing in developing a safeguarding procedure specifically for mental health.

Mr Chambers told committee members the number of recommendations that had transitioned to the ‘business as usual’ designation between May 2024 and May 2025 showed the “significant progress” that had occurred between reports.

Among the “implementation highlights” he cited were the publication of a new national mental health promotion plan, increased wellbeing supports in post-primary schools, and the launch of a Spunout app – a digital tool to help young people access mental health support.

Difficulties

However, Mr Chambers also outlined several issues impacting roll-out. These included recruitment difficulties, and staffing and budget constraints, with 83 problems in these areas reported across all recommendations.

“Other issues in the policy implementation environment were also identified, including increased demand for services, underdeveloped supports at primary care level, HSE restructuring and the need to work in partnership with voluntary and community partners.”

The next implementation period would include a particular focus on developing relationships between national and regional structures.

Feedback was provided by Ms Roisín Clarke, Chair of the NIMC reference group, following Mr Chambers’ presentation. The reference group is an independent body of service users, family members and friends of service users.

On the issue of communications, Ms Clarke noted that improved external communications would promote interagency collaboration and raise awareness of the policy.

The meeting also heard that StV “should be further publicised and awareness raised amongst staff and the public”.

In relation to challenges, Ms Clarke noted that StV required sufficient resources.

She highlighted the importance of long-term investment, particularly in primary care and national clinical programmes.

“Retention and recruitment are vital for StV implementation,” stated the minutes.

The reference group noted “excellent progress” in the availability of multilingual resources under StV.

However, the group also pointed out “more clarity” was needed “in lived experience consultation” and this would help improve “the feedback loop” with
service users.

Final report

Shortages in resourcing and recruitment in mental health were further emphasised in the finalised report, which was published in July.

In her introduction to the Sharing the Vision – Policy Implementation Progress Report, NIMC Chair Ms Catherine Brogan wrote that it was “important to note again” that StV “is dependent on the full resourcing of mental health services”.

She added the NIMC had consistently stressed the need for ringfenced funding for mental health services and for prioritising mental health – particularly in light of the ongoing HSE regional restructuring.

“There is a real risk to policy implementation if resources allocated to mental health are not protected, and the NIMC will continue to advocate for their prioritisation as a key enabler of policy delivery.”

She noted that the NIMC is monitoring recruitment, retention and workforce planning in mental health services as part of its oversight role and that “this remains a standing item in our meeting schedule”.

“I will continue to discuss the paramount importance of human resources as a driver for policy delivery in my scheduled meetings with the Minister for Mental Health.”

Regarding regionalisation, Ms Brogan said the NIMC has organised a series of meetings in the newly established HSE health regions.

“These engagements have been invaluable for us in connecting with local mental health staff, teams, and regional management structures, having a two-way conversation about Sharing the Vision, and seeking to foster deeper collaboration between the NIMC and HSE mental health staff.”

In addition, she said the regional meetings had provided an opportunity for the NIMC to advocate for the “prioritisation of mental health in the new governance structures that accompany the wider
HSE restructure”.

The report noted that compared to the third quarter of last year, an additional eight StV recommendations have transitioned to ‘business as usual’, while significantly fewer recommendations are experiencing delivery issues.

“This is a reflection of the continued progress made within the context of the timelines set out in the new implementation plan,” it stated. 

New steering group

Separately, earlier this month, the Minister for Mental Health Mary Butler convened the inaugural meeting of the interdepartmental steering group for mental health. The meeting brought together representatives from 14 Government departments, along with the HSE, Mental Health Commission and the Office of Public Works.

At the May meeting of the NIMC, reference group members had praised the upcoming creation of this new steering group. They said it would be a “welcome addition” to the governance structure of mental health services and interagency coordination.

According to the Minister, the steering group has been established to enhance cross-Government collaboration on mental health and to ensure that mental health considerations are embedded across all areas of public policy. She added that the initiative “aligns closely” with StV.