Psychiatrists want patients and staff 'immediately' included in Covid vaccination rollout

The College of Psychiatrists of Ireland has called for the 'immediate inclusion' of psychiatric hospitals in the vaccination programme.

The country’s psychiatrists are calling for patients and staff in psychiatric hospitals to be “immediately” included in Ireland's Covid-19 vaccination programme.

The College of Psychiatrists of Ireland (CPI) also said the inability of the Central Mental Hospital (CMH) to take in new patients — as highlighted in a court case this week — was the result of underfunding in the psychiatric services and weak State governance.

The CPI has written to HSE bosses and the health minister advocating equal access to the vaccine for patients with mental illness as for other patients in similar acute or long-term residential units.

The call follows serious concerns from the Mental Health Commission this week at the rise in Covid-19 cases in mental health units and the current exclusion of the majority of them from the vaccination schedule.

In a statement to the Irish Examiner, the CPI called for the “immediate inclusion” of psychiatric hospitals in the vaccination programme.

“The College has always called for parity of esteem, here meaning the same access to vaccination for patients with mental illness, as for other patients in similar acute or long-term residential units,” said CPI president Dr William Flannery.

He said that many, if not most, mental health units are on acute hospital sites. 

He said patients with severe mental illness have a life expectancy significantly lower, by up to 20 years, to that of the general population, because of co-morbid physical illnesses.

Dr Flannery posed the question: “The college asks, will this life expectancy be further reduced when compared to the general population after this pandemic due to differential access to Covid-19 vaccines?” 

He also commented on this week’s court case in which the director of the CMH told Cork Circuit Criminal Court that he could not take in a person with a severe mental illness because the hospital was full.

Professor Harry Kennedy accepted that the HSE was in breach of its statutory obligations to the court.

He said the CMH had two outbreaks of Covid-19 and was unable to admit or discharge patients and that 40 of the 350 staff were out on Covid. He said the only solution he could see was to vaccinate all patients, but said he has not been told by the HSE when that will happen.

Dr Flannery reacted: “The college is very disappointed, but not surprised. Psychiatric services were underfunded before this pandemic, so this was predictable and right now, this is compounded by weak governance structures, as there is no director for mental health and no chief psychiatrist, as called for in the programme for government.” 

In a statement, the HSE said it was rolling out the vaccine programme in line with the provisional vaccine allocation groups the Government had published.

“This is critical given the limited supply of vaccine," it said. "The HSE has developed a set of principles for the sequencing of Covid–19 vaccinations to frontline healthcare workers which supports the Government allocation groups.” 

On the CMH, the HSE said: “Covid-19 has impacted negatively on the capacity at the [CMH]. The HSE is working to making every effort to meet our statutory obligations. The existing CMH is currently operating at 100% bed occupancy.” 

It said the new CMH in Portrane — increasing bed numbers to 170 — was now due to open in mid-2021.