Fears of ‘growing crisis’ in local mental health services

FEARS over a ‘growing crisis’ in the provision of local mental health services have been expressed following confirmation that the 16 bed Sub-Acute Unit in the St James’s Hospital Psychiatric Unit is set to close this week due to nursing shortages.

The Psychiatric Nurses Association (PNA) said the closure of the Sub-Acute Unit will leave just 22 acute admissions beds for the entire catchment area.

This closure of the unit comes just three months after the closure of 11 beds in Linn Dara Child and Adolescent Mental Health unit, Cherry Orchard, which plays a vitally important role in the provision of Child and Adolescent Mental Health Services (CAMHS) in the greater Dublin region.

The association said these beds were due to re-open this month, but it was their understanding that a further seven nurses are due to leave the vital unit in the coming months, potentially jeopardizing the re-opening.

The PNA also said there are also at least 25 vacant posts in the Acute Mental Health Unit in Tallaght Hospital equating to an over 40% vacancy rate.

PNA General Secretary, Peter Hughes said it is ‘totally unacceptable’ that nursing vacancies have been allowed to reduce to such an extent that beds are being closed and vital services are being denied to the communities involved.

“The loss of beds in St James and Linn Dara will have a serious detrimental impact on the delivery of services throughout CH07 area and will put further pressure on remaining services and staff,” he said.

“We are witnessing an exodus of nurses and graduates from our mental health services to pursue opportunities abroad and we need an urgent and imaginative response to adequately staff our services.

“The situations in St James, Tallaght and Linn Dara are symptoms of the wider crisis in the recruitment and retention of psychiatric nurses which is the direct result of failed HSE workforce planning. The HSE must now come forward to target solutions and incentives to encourage the recruitment and retention of nurses to adequately staff mental health services, including CAMHS services, nationally. I have requested an urgent meeting with HSE to address these critical developments.”

The closure of the 16 beds in St James’s Hospital has been described as “another body blow” by Sinn Féin spokesperson for Mental Health, Mark Ward TD.

“The beds in the Sub-Acute unit are a vital cog in a patient’s recovery from mental ill health,” Deputy Ward told Southside People.

“This unit is a step-down service to ease a patient back into their community and onto the road to recovery.

“The closure of these beds comes on top of the decision to close 11 of the 23 inpatient beds in Linn Dara.

“There is a serious problem in work force planning in the HSE. The recruitment and retention problems of health care staff needs to be addressed, particularly in Dublin.

“Information I received from the HSE about exit interviews conducted in CHO 7 for health care workers leaving their posts showed the reasons included:

“Moving to another HSE area – the cost of purchasing property in this CHO area is expensive and staff are generally not in a position to get on the property ladder, particularly those at the start of their career.

“The availability and cost of renting property is also another significant factor.”

Fine Gael Spokesperson on Health, Colm Burke TD, told Southside People:

“Budget 2022 set out record investment in Mental Health overall of €1.149 billion, €47 million more than in 2021.

“This includes funding for two CAMHS telehubs and €2 million to expand the capacity of CAMHS teams.

“Funding of over €1 million was made available for CAMHS under the Government Initiative to tackle Waiting Lists, with a further €2.4 million available later in the year.

“New referrals received in CAMHS in 2021 was 22,613, up 5,177 (25%) from 2020.

“In the same period the new referrals seen also increased to 12,376, up 1,920 from 2020 (17%).

“91% of urgent CAMHS referrals are responded to within 72 hours.

“Almost €10 million over 2021 and 2022 has been provided for the Primary Care Psychology Waiting List Initiative to reduce the number of children and young people under the age of 18 who are waiting more than 12 months to access primary care psychology services.

“Over the 13 months since March 2021, the number of children and young people waiting more than 12 months fell 25% (1,335).

“In addition, 1,600 young people either accessed treatment or were removed from the waiting list between August and December 2021 as a result of the initiative.

Southside People contacted the HSE for a comment in relation to this story, a spokesperson told us:

“In May 2022, the HSE made the difficult decision to temporarily reduce the inpatient capacity at Linn Dara Child and Adolescent Inpatient facility to 13 beds.

“A decision has also been made to temporarily reduce the inpatient capacity of the Jonathan Swift Centre St James to 16 beds. This will take effect from 26th September 2022.

“The capacity issues are not related to any funding difficulties, but are due to challenges in hiring and retaining nursing staff at levels necessary to operate Linn Dara and Jonathan Swift at full capacity while maintaining the necessary standards of care and safety for patients.

“Both centres affected by temporary bed closures will continue to process referrals for inpatient admissions and are working closely with the other HSE / HSE funded inpatient services to mitigate the situation and facilitate admissions where such capacity exists.

“These reductions are reviewed on a constant basis, with the intention to return to full capacity at the earliest opportunity.

“Healthcare settings continue to face a challenging recruitment environment.

“The HSE is actively engaged in comprehensive national and international recruitment campaigns for Psychiatric Nursing staff as well as recruitment from graduate programmes.

“The HSE continues to explore all avenues to recruit and hire Psychiatric Nursing staff.

“As recruitment is ongoing, it is not possible to give a specific reopening date for the affected centres. “The situation remains under constant review with the intention to return to full capacity at the earliest opportunity.”