'A serious concern': Fewer than 60% of beds for children with serious psychiatric illnesses being used

The cutbacks were due to be reversed by September 2022, but have remained in place because of the ongoing shortage of psychiatric nurses and other medical and therapeutic staff.

Fewer than 60% of the beds available for children with serious psychiatric illnesses are being used, HSE figures show.

The number of inpatient beds in the Child and Adolescent Mental Health Service (Camhs) was cut almost two years ago from 72 to 51 as a result of chronic staff shortages.

The HSE has confirmed to People Before Profit TD Gino Kenny that only 30 of those 51 operational beds are occupied — with staff shortages again the reason.

The figures from the HSE show:

• Eist Linn in Cork has 16 registered beds, all of which are currently operational;
• Linn Dara in Dublin has 24 beds, 13 of which are operational;
• Merlin Park in Galway has 20 beds, 12 of which are operational;
• St Vincent’s in Dublin has 12 beds, 10 of which are operational 

The HSE statement said: “Currently, there are 72 Camhs in-patient beds registered with the Mental Health Commission, 51 of which are currently operational. As of the 31 October 2023, 30 of these beds were occupied.

“From time to time, the number of operational beds, ie, those beds available for admissions, can fluctuate below this number based on clinical risk assessment within a specific unit. Examples of such risks would include the availability of appropriately trained staff, the clinical mix, and risks associated with the patients already admitted to the unit."

The statement said: “The current bed reduction across units is due to staffing shortages. Despite reduced bed capacity there continues to be available capacity to admit when a young person requires intensive in-patient treatment.” 

Cutbacks

In May 2022, the HSE cut the number of operational beds at Linn Dara, the largest and busiest Camhs unit, 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 have remained in place because of the ongoing shortage of psychiatric nurses and other medical and therapeutic staff.

The HSE said that Camhs provides specialist mental health services to those aged up to 18 years, who have reached the threshold for a diagnosis of "moderate to severe" mental health disorder that requires the input of multi-disciplinary mental health teams.

These disorders include moderate to severe anxiety disorders, moderate to severe depression, bipolar affective disorder, psychosis, moderate to severe eating disorders, and self-harm which require the input of a multi-disciplinary mental health team.

Responding to the HSE figures, Mr Kenny said: “In this reply to my PQ the HSE has outlined that there is a large deficit of in-patient Camhs beds in the system. This is of serious concern.

“The Children’s Rights Alliance in their annual report card [on Tuesday] gave the Government an E grade regarding continued admission of children to adult psychiatric units. They also noted an unacceptable rise in waiting lists for Camhs.

“It is essential that the Government do everything feasible to attract medical personnel into our mental health services. They need to address the barriers to qualified people taking up employment in the system, including the affordability of housing and cost of living.” 

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In relation to plans to expand inpatient bed capacity, the HSE reply said that a new 10-bedded forensic Camhs unit has been completed within the National Forensic Mental Health Service site in Portrane.

“This new facility, which is expected to be operational by Q3-Q4 2024, is dependent on the ability to recruit staff, will be the first of its kind within the State, and will offer ‘state of the art’ secure care facilities for young people up to the age of 18.” 

It also said that, as part of the Children’s Hospital Ireland (CHI) development, there will be a new 20-bed Camhs unit. This unit will be under the clinical and operational governance of HSE Camhs (Linn Dara Team) and will provide 12 general Camhs and 8 specialist eating disorder inpatient beds.