Mental health services at crisis point amid 'growing demand' - Psychiatric Nurses Association

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Mental health services are at crisis point as staffing shortages are expected to worsen, a psychiatric watchdog has warned.

The current shortage of nurses in mental health services is growing while demand in all aspects of services are increasing, delegates at the annual Psychiatric Nurses Association (PNA) in Wexford have been told.

PNA General Secretary, Peter Hughes said the recruitment and retention crisis shows no signs of easing with emigration of psychiatric nursing graduates, the attraction of better pay and conditions in the private sector.

Mr Hughes pointed out that there is also prospect of 34% of psychiatric nurses retiring by 2021 which is adding to the crisis and called on the HSE to lift the embargo on recruitment for mental health staffing such is the crisis they are in.

Even now the HSE solution to the crisis has been to impose an embargo on all recruitment from April. This move is only adding to the staffing crisis and I am calling on the HSE to immediately introduce derogation from this embargo for mental health and intellectual disability services.

Mr Hughes added that the near collapse of mental health services in some parts of the country during the recent PNA ban on overtime highlighted the reliance of the services on overtime and agency staff, and the lack of staff throughout the system.

“This situation must end and highlights the urgency in concluding the negotiations on the settlement of the recent nurses’ dispute.

"The lethargy shown in bringing these negotiations to a conclusion is itself an indication of the Government’s lack of urgency in solving the staffing crisis in nursing and moving on to invest and develop services to meet the growing demand for mental health services.”

Mr Hughes revealed that the staffing of the new National Forensic Mental Health Services in Portrane, which will be completed by the end of this year, will be a major challenge in the context of a recruitment crisis and will require major initiatives in order to attract staff to work in the new facility.

“This transfer of services is by far the biggest for mental health services in the history of the State. It will bring with it many challenges and opportunities and the biggest challenge will be staffing as the additional 74 beds will require approximately 200 additional nurses.

“(The) PNA will not be wanting in meeting these challenges, but it will require concerted agreement on finally addressing the issues underlying the recruitment and retention crisis.”

Addressing issues around what Mr Hughes called “underinvestment and inadequacies” in the Child and Adolescent Mental Health Services (CAMHS), despite HSE and Government repeated assurances, families and patients nationwide were suffering “severe consequences” as a result.

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The Association claims that there is now a shortfall of 12 Day Hospitals with the closure of Linn Dara day facility and only 66 of the recommended 100 beds in Vision for Change policy document are operational with multidisciplinary teams remaining inadequately resourced.

Delegates also heard that waiting lists for first time assessments are more than 2,500 and that there were 81 Admissions of Children to Adult Psychiatric Units in 2018.

Mr Hughes dismissed the proposal of Junior Mental Health Minster Jim Daly, for the introduction of tele-assessments, where children would be assessed a remotely online by a psychiatrist

Can I say to Minister Daly, that the assessment of mental health problems does not lend itself in any way to this impersonal approach. People with mental health problems need assessment on a direct one to one interpersonal basis.

"I call on the Minister to abandon this inappropriate solution to a staffing crisis and introduce meaningful measures to attract staff to the services.”

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