Child psychiatric admissions fall 40% due to staff shortages

The Camhs-approved centre at Merlin Park Hospital in Galway saw its admissions numbers fall from 88 in 2021 to 61 in 2022, with 34 cases this year.

Psychiatric nurses, psychologists, and mental health campaigners are calling for “urgent” action to address a continuing shortage of child inpatient psychiatric beds.

HSE figures supplied to the Irish Examiner show a 40% drop in admissions to the four public Child and Adolescent Mental Health Services (Camhs) approved centres last year due to staff shortages.

The numbers fell from 361 in 2021 to 218 in 2022 — and there have been just 98 admissions so far this year.

The continuing problem stems from a decision over a year ago to cut the number of operational beds due to persistent staff shortages.

Psychiatric nurses warn the situation is “not sustainable” and that it needs to be “urgently addressed”.

The country’s psychologists said it is “unacceptable” that children whose condition is so serious that it requires inpatient care cannot access it.

In May 2022, the HSE cut the number of operational beds at the largest Camhs unit, Linn Dara in Dublin, from 24 to 13.

This brought the total number of beds across the four approved centres to 51, down from 72.

The cutbacks were due to be reversed by September 2022, but remain in place over a year after they were announced.

The Psychiatric Nurses Association (PNA) said that, according to its estimates, there are only 43 beds in operation, not 51.

It said updated HSE plans to reopen the Linn Dara beds this September seem “unlikely” given ongoing recruitment and staffing difficulties.

HSE figures show:

• Linn Dara admissions halved from 153 in 2021 to 76 in 2022, with just 31 admissions so far this year;
• St Joseph’s in Dublin saw its admissions fall from 75 in 2021 to 53 in 2022 (down 29%), with 25 so far this year;
• Eist Linn in Cork witnessed a 38% reduction in admissions, from 45 in 2021 to 38 in 2022, with only eight admissions so far in 2023;
• Merlin Park in Galway saw its numbers fall from 88 in 2021 to 61 in 2022 (down 31%), with 34 cases this year.

In a statement, the HSE said the continuing reduction in operational beds in Linn Dara is due to “high levels of nursing staff vacancies”, but said there continues to be a “concerted recruitment campaign”.

St Joseph’s has seen its operational beds reduce from 12 in 2022 to eight this year, which the HSE said is due to staff vacancies.

It said Eist Linn had received “significant investment” in putting in a high observation suite and it has maintained its operational capacity at 16.

Merlin Park's capacity reduced from 20 to 16 in August 2022 after making all rooms single rooms, although this has now reduced further to 14, due to nursing shortages.

“Nationally PNA estimate that there are just 43 operational beds where Vision for Change recommended there be 100,” said the PNA in a statement.

This situation is not sustainable and needs to be urgently examined and addressed and a creative and innovative way of recruiting staff and retaining them must be developed urgently."

Psychological Society of Ireland president Anne Kehoe said they have “huge concern” over access to inpatient care.

“It is essential that we have the capacity to meet the needs of vulnerable children and young people suffering from significant mental health difficulties as there may be nowhere else for them to go.” 

She said the consequences could be “devastating” for a child and added: “In 2023, this is unacceptable.”

Mental Health Reform CEO Fiona Coyle said: “Unless recruitment and retention issues are urgently addressed, children will continue to be denied the appropriate mental health care they require.”