independent

Sunday 25 August 2019

Unfilled psychiatric posts 'causing delays'

One hundred permanent psychiatric consultant posts across Ireland's mental health services are currently either empty or only temporarily filled, according to the Irish Hospital Consultants Association (IHCA).

They say the lack of available psychiatrists to treat patients is restricting timely access to much needed services for patients with mental health difficulties and adding to the long wait times experienced by patients across Ireland.

The number of unfilled consultant posts was revealed as part of the representative body's #CARECANTWAIT campaign, which seeks to highlight the impact of long waiting times on patients across Ireland.

In a new campaign video, released on Monday Consultant Psychiatrist Dr. Selena Pillay talks about the impact of long waiting times on the patients she treats every day.

The HSE's own data also highlights the fact that accessing mental health services is an issue for all age groups, from children, adolescents to adults and older and vulnerable adults.

Recent HSE figures for Q1. 2019 show:

◾ 2,498 children are waiting to access mental health services;

◾ 3,764 adults were waiting to access mental health services;

◾ For both categories, one-in-four of those referred by their GP to mental health services were not seen within the HSE's recommended 12-week period.

In addition to the numbers waiting, the Government has also failed to establish and adequately staff mental health services across Ireland.

The Government's National Mental Health Plan, 'A Vision for Change' was first published 13 years ago, in 2006, and set out a blue print for the delivery of these services, yet staffing remain hugely under resourced.

The HSE's own Mental Health Services Workforce Planning Report (October 2018) confirms this deficit of resources.

Children and adolescent services have about 50% of the specialist staff they need, this is also the case for older people's mental health services, while adult services have 25% less than is needed.

Several mental health experts have pointed to the increasing use of medication by Irish patients as being linked to the difficulty patients encounter in accessing mental health services.

Data covering the period 2012 to 2016, shows prescribing of antidepressants on public health care schemes increasing by 18% and costing the HSE €40 million annually. There is no indication that this figure has since reduced.

IHCA President, Dr. Donal O'Hanlon, Consultant Psychiatrist commenting on the crisis noted: "There is a lack of joined up thinking currently in the delivery of mental health services. The resourcing of our mental health services is 'in limbo', because of this, patients cannot access the range of talk and behavioural therapies that should be available to them in a modern mental health service, while in parallel, the State's spend on medication to treat patients with mental health difficulties is growing. For example, the HSE's spend on antidepressants has grown to over €40 million per annum. Medication, while an important part of treatment for many patients, must be part of a wider care programme, supported by a range of therapies provided by a full team of mental health specialists".

"The consultant crisis is severely impacting on the delivering of health services to many of our most vulnerable people. It is now the 'new norm' that many consultant psychiatrist posts advertised nationally either have no applicants or only one applicant".

"This leads to two outcomes - these posts remain indefinitely empty or non-specialists are temporarily appointed to specialist psychiatry posts. Both are contrary to the delivery of safe and timely mental health services."

"Ireland, with 6.1 consultant psychiatrists per 100,000 population, has just half the EU average number of specialists and one third to one quarter the number in many EU countries. This low level will deteriorate further until the Minister for Health, who acknowledges there is a problem, addresses the consultant crisis. To date, he has failed to do so," added Dr. O'Hanlon.

Consultant Psychiatrist Dr. Selena Pillay said: "They [patients] become more unwell, need more medications and they also require hospital admissions. This is not good for patients; we need to get them at an earlier stage of their illness."

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