Two-thirds of people referred to self-harm service are in life crisis

TWO-THIRDS of people referred by their GP to a new service to help people with suicidal tendencies before they harm themselves had become overwhelmed by a severe life crisis, it has emerged.

The Suicide Crisis Assessment Nurse (SCAN) programme, launched in March 2007 by the Cluain Mhuire Service in Blackrock, Co Dublin, provides a fast-track priority referral system from primary care for people experiencing a suicidal crisis.

Psychiatrist and clinical director of the Cluain Mhuire Service, Dr Siobhán Barry, said improving access to quality mental health services was one of the essential components of the national suicide prevention strategy Reach Out.

Cluain Mhuire was also involved with the Health Service Executive in setting up a similar service in Wexford, initially on a pilot basis and with just one clinical assessment nurse.

In August the Wexford service, that now consists of three nursing posts, was rolled out across the county.

The establishment of the service in Wexford was part of a number of steps taken by the HSE after father of two Adrian Dunne orchestrated the deaths of his wife, Ciara, and two young daughters, Leanne and Shania.

A study of 100 referrals to the service in south-east of Dublin found that two-thirds of people referred by their GP were not mentally ill.

“They were suffering from a life crisis that was overwhelming and the intervention was neither pills nor hospitals,” said Dr Barry.

Such patients, who were in financial or relationship difficulties or had lost their job, were guided towards the support they needed.

Dr Barry said the people who were availing of the service were not as chaotic as those who ended up in a casualty department after self-harming.

They appeared to recognise that they needed help.

Referrals to the service are made by the GP who calls the nurse on her mobile phone and the patient needing help will be seen within hours, or the same day.

Cluain Mhuire, however, only has enough funding from the National Office for Suicide Prevention to provide the service until March 2010. It is operated by one nurse five days a week from 9am to 5pm.

The National Office for Suicide Prevention also confirmed that the funding agreement for the Wexford service also expires next March.

Dr Barry said the Dublin service was initially provided between 1pm and 9pm but a look back over the first three months found that the vast majority of referrals came in earlier in the day, which is why the service now operates during office hours.

She said the number of referrals to the service averaged at around three a week but, while the figure was small, the assessment process was both intensive and time consuming.

“I am unaware of anybody who has been assessed through this system that has come to a tragic end,” she pointed out.

Director of nursing for the HSE’s Wexford Mental Health Service, Kevin Plunkett, said GPs only had to have a concern that a patient might self-harm to refer them to the suicide crisis assessment nurse.

“The number of people being referred to the service in Wexford is increasing but that is probably because we are meeting a need that is already there, rather than an increasing need,” he said.