HSE aims to make specialist suicide crisis nurses available to GPs countrywide

Mental Health Minister Mary Butler said funding from Budget 2022 has been allocated to recruit six additional SCAN nurses across four mental health services. File picture: Gareth Chaney/Collins 

The HSE aims to make suicide crisis assessment nurses available to all GPs across Ireland, as part of a revised model which seeks to provide more crisis support in primary care settings, rather than emergency departments.

Almost half of all presentations (47%) to emergency departments between 2018 and 2020 were due to suicidal ideation.

In an update to its National Model of Care for Self Harm and Suicide Related Ideation, launched on Wednesday, the HSE highlighted that “the ED is not a suitable place for people who are suicidal but have no physical health needs, and that people assessed in the ED, rather than in a non-ED mental health service, have a higher rate of admission”.

The updated model of care recommends having a suicide crisis assessment nurse (SCAN) service available to GPs in local areas in all parts of Ireland.

SCANs provide assessment and support to GP patients who present with suicide-related thoughts. They provide an early intervention to patients who may otherwise be referred to emergency departments, or placed on a waiting list for a community mental health team.

SCANs are currently in place in eight services across the country, and are used by 230 GPs, covering about 20% of the population.

The updated care model, if implemented, will make a SCAN available to every GP in the country.

Patients would be seen by a SCAN within 72 hours of referral by their GP, and where possible the SCAN will conduct an assessment in the patient’s own general practice.

Emergency safety plan

A SCAN would conduct a full biopsychosocial assessment, liaise with family or friends with the patient's permission, develop a written emergency safety plan, and provide feedback to the GP.

In all cases, the SCAN would provide a follow-up phone call within 24 hours of first assessment, and where required, up to three follow-up appointments.

Dr Amir Niazi, national clinical adviser and group lead for mental health, said the national SCAN service was an important feature of the new model of care that goes beyond treatment in acute hospital settings.

“SCAN has already been piloted and implemented successfully in some areas. It will be rolled out nationally in the coming years as a collaboration between GPs and specialist mental health professionals, with the aim of delivering a service of similar quality of for people who present in suicide crisis in primary care settings,” he said.

The HSE estimates that one SCAN practitioner for every 75,000 people will be required, which equates to more than 65 nurses to cater to Ireland’s 5m population.

Mental Health Minister Mary Butler, launching the revised model of care, said funding from Budget 2022 has been allocated to recruit six additional SCAN nurses across four mental health services.

“This will build on the 12 SCAN nurses already providing a service to GPs. This extra six will bring us to 18, but we can't stand still. The updated model of care provides a real opportunity to provide rapid, emphatic and effective response with the incremental development of SCAN in primary care settings across the country,” she said.