Psychiatric patients not as closely monitored as before, says top nurse

Modern psychiatric care methods have resulted in patients not being as closely observed as they were in the past, it has emerged.

“If we want to endorse a policy which says that we nurse patients in the least restrictive and intrusive environment, we are then taking risks,” said Psychiatric Nurses Association (PNA) general secretary Des Kavanagh.

The HSE has confirmed that two separate tragic incidents occurred in mental health services on Monday.

One patient, a man in his 30s, died at the acute mental health unit at Kerry General Hospital in Tralee and another, a woman in her 40s, died at the HSE acute mental health unit on the grounds of Tallaght Hospital in Dublin. Both incidents, described by the HSE as “tragic incidents”, were unconnected. The health authority has begun comprehensive reviews.

Mr Kavanagh said such deaths were infrequent.

“Every effort is made to provide a safe environment for patients. At the same time nowadays we are required to nurse patients in what’s referred to ‘the least restrictive environment’,” he said yesterday.

In the past, psychiatric patients would be nursed in dormitories whereas nowadays they are often nursed in observation areas and single rooms. Mr Kavanagh said that where possible, attempts were made “to provide the least intrusive nursing care” but this was a challenge when it came to people who wanted to self harm.

He said a patient might tell a member of staff they had no suicidal ideation and then try and end their own lives an hour later. He said there had been a 25% cut in psychiatric nursing posts and the sector had been the worst hit of any frontline service in the country.

In 2010, psychiatric nurses represented less than 5% of the total HSE workforce. However, they accounted for 44% of those who left the mental health services and were not replaced.