'Glaring gaps’ in mental health services must be tackled in post-Covid Ireland, says PNA
The Psychiatric Nurses Association has warned that “glaring gaps” and a funding shortfall must be tackled if already stretched services are to meet an expected increased demand for support due to the Covid-19 crisis.
In a letter to the Taoiseach, health minister, and leaders of Fianna Fáil and the Green Party. PNA general secretary Peter Hughes called for an end to “lip service and idle promises” on mental health services.
As government formation talks continue, the organisation, which represents 6,000 psychiatric nurses and students across the country, is urging the prioritisation of mental health services in the next programme for government.
Decades of underinvestment in services need to be “reversed” in particular as services face increased demand due to the effect of social isolation, unresolved grief with the loss of loved ones, stress on frontline healthcare workers, and the economic fallout from the public health emergency, the organisation said.
Social distancing, Mr Hughes said, could also reduce existing bed capacity and for that reason 24/7 crisis intervention units are needed to deliver care in the community now more than ever.
“There is going to be a huge demand for mental health services and the resources have to be put into that, including 24-hour services. Mental health services don’t stop at five o’clock on a Friday evening or any day; there needs to be 24-hour community services,” Mr Hughes told the Irish Examiner.
Mental health funding has fallen from 16% of the overall health budget in the 1980’s to just 6% this year and planned investment under Slaintecare at 10% of the overall health budget also falls short of international best practice (16%), said the PNA.
It seems we are again planning for underinvestment in mental health services where Sláintecare recommends 10% of the health budget should go to mental health services while international best practice recommends 16%.
Other challenges include more than 700 nursing vacancies across the service and acute psychiatric beds are operating above capacity on an ongoing basis.
“Over 70% of beds were taken out of the system under Vision for Change and only 30% of the promised community mental health beds were developed. Basically Vision for Change was used as a cost-saving mechanism,” said Mr Hughes.
“They closed down large institutions, reduced bed capacity, and did not put in place the community resources needed and that’s why we have 120% bed capacity. There are more patients than there are beds,” he said, adding that Ireland has the third-lowest number of psychiatric beds per 100,000 population in the EU.
The PNA said there are gaps in child and adolescent services with children still being admitted to adult mental health units, as well as a "postcode lottery" for out-of-hours care and more specialist services for eating disorders, early intervention psychosis, and rehabilitation and recovery.
Mr Hughes said there is a now a greater urgency to address deficits in services given the additional challenges posed by the Covid-19 public health emergency: “There has been too much lip service and idle promises on addressing the critical issues across our mental health services. This will have to stop, and we must see real evidence of a renewed determination to address the under-investment and glaring gaps in service provision throughout the country.
“This will never be as urgent and pressing as in the years ahead post the Covid-19 pandemic when we must be able to build capacity, and innovate at all levels of our services so that care can be delivered to all those who need it."
