Minister defends psychiatric services

Mental health minister Kathleen Lynch has said there are no resource issues in psychiatric services in Carlow, Kilkenny and South Tipperary, even though nine people died in the service between August 2011 and January 2013.

Mental health specialists in the area have said they have “no confidence” in the clinical management of the service which they describe as “unsafe”. Nine of the area’s 13 psychiatrists voiced these “serious concerns” to the HSE at the end of 2012, but little changed, they said.

Six months later they wrote a similar letter to Ms Lynch but said they never received a “proper response”. Since the end of 2012, the psychiatrists have refused to take part in HSE clinical governance meetings as they believe the system “isn’t safe”.

The nine deaths were made up of suicides by in-patients, suicides in home-based settings and another suicide in a crisis house. Since these letters were written by the psychiatrist, another four deaths have taken place.

The consultants are calling on the minister to intervene with the HSE to ensure proper investigation of incidents and that recommended reforms are implemented

One retired psychiatrist, Dr Alan Moore, told RTÉ’s This Week the death rate among in-patients and among patients in regular contact with day services was “extraordinary and well above accepted norms”.

Clonmel GP Dr Damian Sharp has said the home-based teams that replaced acute psychiatric facilities in the area are “not fully staffed”. He described the lack of community psychiatric investment in the South-East as “worse than anything I could have imagined”.

He argued that Cork North Lee Mental Health Services, in the minister’s own constituency, have “one consultant psychiatrist, one registrar, one junior doctor, six senior nurses, a psychologist, social worker and an occupational therapist in their home-based teams. In contrast, the home-based services at Carlow Kilkenny and South Tipperary only have “a few nurses” yet they too each look after a population of 100,000.

The psychiatrists sought copies of mandatory reports completed by the HSE after an unexplained death in the service. It took five months before they were given the reports under FOI.

Responding to their criticism, Ms Lynch said she “would not accept” that the death rate in the service was “extraordinary”. She had asked the HSE to look at the death rate when she received the doctors’ letter last year. She said the Department of Health “takes it very seriously” when people die in the service but added there are “no resource issues” in the area. Instead, she said “some people are resistant to change”.

It was March 2014 before the Mental Health Commission decided to investigate the deaths. The minister is awaiting this report, with a separate report into the matter by Dr Colm Henry, the National Lead of the Clinical Directors’ Programme.