Riot squads restore calm in psychiatric units

MENTAL health services are in “free fall”, with nurses and patients subjected to increasingly violent attacks, staff leaving in record numbers and gardaí and riot squads frequently called in to restore calm to acute and secure units.

A damning report by the Psychiatric Nurses’ Association has claimed the service is being allowed to “disintegrate” with no regard for quality of care or safety.

According to the report:

* Patients who need to be hospitalised are refusing to be because of fears arising from previous experiences.

* Gardaí are increasingly called to assist in acute and secure units in recent years.

* In all, 20% of psychiatric nurses have retired from the HSE over the last two years, including almost 600 last year, leaving the service in “free fall”.

* The HSE is considering amalgamating an intellectual disability unit with a psychiatric rehabilitation unit to achieve savings.

* Security companies are being employed because of the threat posed by some patients and the shortage of male nurses.

According to the report, five nurses are on sick leave following assault and injury at the admission unit of St Ita’s in Portrane, Dublin, where there have been 30 assaults on staff in the first six months of this year.

In Tallaght Hospital, an elderly patient was stabbed; while in a secure unit for men at St Brendan’s, Grangegorman in Dublin, the levels of violence have “increased substantially”, the report says.

It adds that on one occasion eight gardaí in riot gear had to come to the assistance of nurses managing one aggressive patient.

In total in 2009, there were 1,314 assaults on staff.

Despite government commitments, the budget for mental health services is at its lowest ever, at just 5.3% of the overall budget, as opposed to the 8.4% recommended by a Vision for Change.

“We are experiencing crisis after crisis on a daily basis. We have lost 1,500 staff over the last three years and this is rising,” said Des Kavanagh, general secretary of the PNA.

“There is a huge increase in the numbers being admitted, and we are seeing levels of violence that we have not seen before, or are used to. It is frightening.”

According to the report, retired staff are now being re-employed in part time work to “maintain some semblance of service to patients”.

At the same time, highly committed, well-educated and enthusiastic young graduates are being forced to emigrate.

“It is economic madness to be denying employment to these young graduates while incurring excessive costs in using overtime agency and retired nurses to plug the gap,” the report states.