One-in-ten mental health beds ‘un-operational’ across West

Prof Ann Doherty

Prof Ann Doherty

Hospitals in Galway city are “particularly tricky” places to treat acutely mentally unwell patients because of a lack of appropriate beds, according to a leading psychiatrist.

Galway’s former consultant Liaison Psychiatrist, Professor Anne Doherty, says a complete lack of high dependency beds for psychiatric cases who would benefit from preventative inpatient care is startling in Galway, and across the Western region acute beds are constantly full.

Prof Doherty is vice president of the Irish Hospital Consultants’ Association which this week shared an unpublished HSE report showing that the west of Ireland has the highest percentage of out-of-use acute mental health beds across the country.

Figures from an unpublished HSE audit report show 11 per cent of inpatient psychiatric care beds in the Galway-Mayo-Roscommon region were not operational, with 66 of the area’s 74 registered beds in public and private healthcare settings deemed usable.

Of the operational beds in the old Western Health Board area, 100 per cent were occupied, compared against the national average of 88 per cent for high support beds. Only the Clare-Limerick-North Tipp region shared this full capacity figure, although all other health areas had high operational bed occupancy levels above 84 per cent at the time of the bed audit.

Prof Doherty was a HSE psychiatrist in Galway from 2016 to 2020, running a team which liaised between emergency departments and acute mental health units. She says her team consisted of “fabulous nurses, grossly underfunded” who could not deliver a proper service to patients because of staffing and bed issues.

“Galway… was a particularly tricky place. Normally of a weekend on-call there would literally be no beds, and I’d be literally praying the guards wouldn’t bring in someone who absolutely needed to be admitted. You can’t leave someone like that in the ED; it isn’t the appropriate place for these patients, for them or for others next to them, and there was always the high chance they’d abscond.”

The Irish Hospital Consultants’ Association (IHCA ) obtained the unpublished HSE figures via a Freedom of Information request after results of a national bed audit in November 2021 were never released. The IHCA issued a statement in response to this report highlighting how the HSE’s shortfall of 830 acute psychiatric beds nationally may be an underestimate, and the true deficit is more like 1,800 beds.

“With only 23.8 adult acute mental health beds per 100,000 population in public approved centres in Ireland, compared to an EU average of 73 beds, inpatient psychiatric care is now reserved only for the ‘seriously ill’,” says Prof Doherty.

According to the last figures available, the average length of stay in an acute psychiatric bed in the Galway region was just under 23 days in 2021, down from 29 days in 2019. This compares to 20 days down from 26 nationally, during the same period.

As of September 2021, there were 1,335 mental health staff in the Galway-Mayo-Roscommon area, the second highest in the state after the Cork-Kerry region, and per 100,000 population this figure is above HSE staffing targets. However when the west of Ireland figures are broken down by discipline, staffing levels for Psychiatry of Later Life (POLL ) services are more than 10 per cent below target, with Child and Adolescent (CAMS ) staffing a worrying 37 per cent below levels indicated in the HSE’s ‘Vision For Change’ policy for mental health, originally set out by government ministers as far back as 2006.

The latest Irish Nurses & Midwives Organisation (INMO ) figures from last Monday, 1 July, show there were 56 patients waiting on trolleys in University Hospital Galway, 41 of whom are in the Emergency Department.

The IHCA estimates the Government must invest more than €6bn to meet its commitments on public hospital capacity, and reduce waiting lists. This equates to €3.3bn to deliver 3,000 beds nationally by 2031, plus €3bn for four elective hospitals, including Merlin park.

 

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