According to the final report[/url] of the expert review group on community mental health services in Galway/Roscommon, published over the weekend, the area also costs the HSE more per rate of admission than other, higher-density areas.
The review looked at community hostels/group homes, day hospital services, day centres, and training centres and found that services in the area were operating under the outdated 30-year-old national strategy Planning for the Future 1984, rather than the current Vision for Change document.
In his foreword to the report, team chairman Pat Dolan said that Galway and Roscommon have operated as three separate catchments — East Galway, West Galway and Roscommon — and that “It would be fair to say that they are ‘in contention’ with each other for resources”.
“These catchments have not yet implemented Vision for Change, and the service delivery model very much reflects Planning for the Future Models of Service.
“It has to be acknowledged that there is a ‘legacy’ of long-term inpatients who are currently residing in hostels, many of whom would have severe and enduring mental health problems,” he said.
The review found excellent examples of good practice being carried out by dedicated and committed staff, but also problems.
* “Very high” admission rates, particularly in Roscommon and West Galway, double the admission rate of Cavan/Monaghan which have implemented Vision for Change;
* 22 hostels in the Galway/Roscommon catchment, housing 188 residents, where Vision for Change would recommends a maximum of nine hostels;
* “It could be claimed that residents are ‘over-cared’ in a ‘model of dependency’ and denied (not deliberately) any hope of ever reaching their full potential”;
* A lack of key performance data on patients, by hostel, by category, by bed numbers, by diagnosis, by age profiles etc;
* “Significant variations” in budgets compared with client base — “East Galway, which has 39% of total population for Galway/Roscommon has 54% of budget and 49% of WTE (whole time equivalent). West Galway has 40% of population of region but has only 24.5% of budget and 25% of WTE, despite the fact it has the largest Inpatient Unit”.
It said: “The high percentage (54%) of residents in high/medium/low supports for periods in excess of 36 month suggests that some residential facilities have become a continuing care facility rather than a rehabilitation centre.”
The report recommends a new multidisciplinary catchment team and Home Based Treatment Teams and the implementation of “basic IT systems” for Patient Management. It said hostels should be limited to seven beds.
* Read the report online at http://exa.mn/5k