Mental Health Commission urged to investigate psychiatric admissions

A man who presented at the emergency department of UHG for psychiatric admission left the department without supervision and was missing for 36 hours.

The man was in a distressed state as he awaited admission, according to his mother who contacted the Fianna Fáil spokesperson on mental health Colm Keaveney about the incident.

The Tuam TD has called on the Mental Health Commission to initiate an investigation into the management of psychiatric admissions at UHG.

“The mother of the man involved in this incident contacted me recently and was extremely traumatised by the situation. It is completely unacceptable that a person with mental health issues was forced to wait unattended in a chaotic emergency department.”

Deputy Keaveney believes the closure of St Brigid’s Hospital in Ballinasloe has led to a “serious deterioration” of mental health services in Galway.

“The triage system in an emergency department is not properly suited to deal with people in mental distress. That is not a criticism of the staff, it is simply not appropriate for psychiatric admissions to be forced through EDs. I have been told by sources in UHG that the ED is unable to cope with the number of people coming through the doors. There are cases of patients sleeping on the floor because the unit has breached its maximum capacity of 45 beds.”

He is laying the blame firmly at the feet of Minister Kathleen Lynch. “It was her decision to close the psychiatric unit in St Brigid’s Hospital Ballinasloe and she has failed to honour her promise to fund community mental health care structures. Minister Lynch has presided over a €60m underspend in mental health services nationally, €6m of that is specific to Galway.”

He claims mental health services in Galway have been decimated as a result of this. “Staff in the psychiatric unit in UHG are being left to deal with a workload the department was never designed for and for which it is ill-resourced. The physical condition of the unit is poor.

“It is too late now for the current government to repair the damage that has been done to mental health service in the Galway area. This will now fall to the next Dáil to address this. Mental health deserves to be a key part of the public debate in the upcoming general election.”

In a statement Saolta University Health Care group said Galway University Hospitals cannot comment on individual cases. However it outlined that the general process around psychiatric patient review in the ED is that psychiatric patients who present there are triaged in the emergency department.

“Following triage, ED staff will contact the psychiatric advanced nurse practitioner (if during the day or the psychiatric doctor on-call if out of hours ) and either the advanced nurse practitioner or doctor on call will come to the ED to review the patient and make a decision with regard to the appropriate care plan for the patient.”

It went on to stress that management at GUH remain committed to working with all stakeholders to address the challenges the services face, particularly in its emergency departments.

“GUH emergency department has approximately 64,000 attendances annually and faces similar challenges to peer hospitals in Ireland and we continue to focus on patient dignity and care. There are capacity issues and we are working hard to address ‘patient flow’ through the system. We have implemented various initiatives to improve the pathways of care on a whole systems basis, including a navigational hub and an early discharge programme. We are developing a pathway for frail elderly and are accessing short stay beds in the community as well as intensive home care packages for our patients. We continue to work with Primary Community and Continuing Care on the implementation of the community intervention team to enable timely discharges from the acute setting.

“We have a winter contingency plan in operation that includes reduction in elective activity, prioritised access to diagnostics and maximisation of use of short stay beds in the community and we will be opening rehabilitation beds in Merlin Park University Hospital in parallel with the closure of St Rita’s Ward.”

The statement continued that GUH also works closely with Saolta University Health Care Group in a bid to optimise the use of all available beds in hospitals across the group.

“Additional accommodation for 17 inpatients opened on January 4 2016 located close to the emergency department at UHG and this will provide much needed additional inpatient beds. This is the first part of an additional 30 inpatient spaces at this location and it is expected that the remainder will open in February. The provision of this additional inpatient accommodation will assist in our efforts to admit patients as quickly as possible to the hospital.

“We have an urgent requirement to replace the emergency department at UHG to meet current and future capacity requirements. This is a priority for the Saolta Group. As with any capital project there is an approval process that has to be followed through the HSE’s National Capital Steering Committee and further work is being undertaken at a local level as part of that process. In the meantime work is continuing on the construction of a new 75 bed ward block which will provide single room in-patient accommodation and is expected to be completed in 18 months.”

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