National Audit Office: The state has let people with special psychiatric needs down

Toomas Mattson | 3/3/2008 | 12:00 AM

Text size: [-A] [+A]

Language: EST | RUS | ENG

Print

TALLINN, 3 March 2008 - An audit carried out by the National Audit Office has revealed that not all special psychiatric needs cases are being granted welfare services when they require them. This has led to a situation in which these individuals or their carers – who in the event of adequate services would be able to make themselves useful to society in some other way – are being forced to join long queues in order to obtain the services.

The Ministry of Social Affairs has conceded that while there are significantly more people who require social welfare services than are obtaining them, it is unable to guarantee state assistance to all of them.

Even in the case of individuals for whom such services have been prescribed by the courts due to them representing a danger to themselves or others, the state is unable to ensure that they will obtain the services immediately. The National Audit Office’s investigation showed that on average these services are only granted six months after a court ruling is made.

There are also problems with the quality of these services. As there are no standards for the provision of such services and the applicable quality requirements are minimal, there is no guarantee that individuals will receive services of the same standard in all areas. Neither does supervision of service providers necessarily lead to improvements in the quality of services, as the county governments audited perform either minimal supervision or no supervision whatsoever.

The main reason for the poor availability of these services is insufficient funding. The prices charged for provision of the services do not accord with the actual costs of providing them. Over the years the prices have only risen by the same amount as labour costs, but this has not managed to secure qualified staff or reduce staff turnover. Underfunding is also the reason for the lack of a significant increase in recent years in the range of services being offered.

The audit confirmed that no solution has been found to the problem of specialist care for the elderly. Although care of the aged is the remit of local governments, to date it has mostly been the state that has provided financing for elderly people with special psychiatric needs. While it is the position of the National Audit Office that the organisation of care for people with special needs must not be based on age, it will allow that one of the reasons for the unsatisfactory availability of services is the unresolved problem of care for the elderly with special needs.

Individuals receiving 24-hour care services must cover their accommodation and food costs as their circumstances allow, but almost a third are unable to do so on their incomes. As a result, the service provider is forced to make up the difference from the already small amount it receives for the services.

According to the Ministry of Social Affairs, there are around 7000 people with special psychiatric needs who require care services. Less than 4500 of them are being granted such support.

171.1 million kroons was allocated to the care of individuals with special psychiatric needs in the 2007 state budget.

The Minister for Social Affairs thanked the National Audit Office for its audit and admitted that there is still room for improvement in the system of state care for people with special psychiatric needs. The minister confirmed that the ministry is working to provide the highest quality specialist care services possible at reasonable prices to all of those who need them. The minister says that many of the remarks and proposals made in the audit have already been taken on board.

The Minister for Regional Affairs also agreed with the National Audit Office’s recommendations, adding that reinforcing and improving the efficiency of the state supervision carried out by county governors has become a priority and that county governments have increased the amount of planned supervision in their policy papers for 2008.

* * *

The National Audit Office carried out an audit of state care of people with special psychiatric needs in order to assess its efficiency and to determine whether all of those who require appropriate services are obtaining them. Individuals with special psychiatric needs are classed as those with mental and/or psychiatric disturbances whose conditions significantly affect their everyday lives.

The National Audit Office based its assessment on the premise that the care system could be said to be operating effectively were everybody with special psychiatric needs able to obtain the care services they required within a reasonable time when they needed them, without their rights being infringed in the process. In such a case the state would be able to guarantee that all service providers were providing services of the required quality and to finance the services in accordance with the actual cost incurred in their provision.

Toomas Mattson
Communication Manager of National Audit Office
Telephone: 6400 777
Mob: 51 34900
E-mail: toomas.mattson@riigikontroll.ee

  • Posted: 3/3/2008 12:00 AM
  • Last Update: 9/15/2015 10:14 AM
  • Last Review: 9/15/2015 10:14 AM

More News