Mental health services short more than 800 beds, report reveals

Adult beds were completely full at St Stephen’s Hospital in Glanmire. Picture: Dan Linehan

The mental health services are 832 beds short of recommended levels, according to an unpublished HSE report, with psychiatrists warning that the true deficit may even be twice this figure.

On one night, beds for adults at a number of centres were completely full, including at St Stephen’s Hospital in Glanmire and the unit at University Hospital Kerry.

Others including in Mayo and Letterkenny were unable to open all beds they are registered for, which could have been due to staff shortages or restrictions imposed for infection control, the report indicates.

In all some 8% of registered beds could not be opened.

The report concluded that all eight HSE regions “report a shortfall in the number of beds”. 

This is compared to levels recommended in the 2006 ‘A Vision for Change’ and the Oireachtas Joint Committee on the Future of Mental Health.

This report on acute bed capacity by a specialist group set up in 2021 by the HSE was released under the Freedom of Information Act to the Irish Hospital Consultants' Association.

Professor Anne Doherty, IHCA vice-president, warned shortages mean “inpatient psychiatric care is now reserved only for the ‘seriously ill’” in Ireland.

Prof Anne Doherty said shortages mean inpatient psychiatric care is reserved for the 'seriously ill'.

She said the negative impact this has on “people’s mental health and their ongoing care needs” is being continually highlighted, but “lessons are not being learned” yet.

When I graduated from medical school in 2005, there were 4,000 acute mental health beds in Ireland. That number has now decreased to around 1,100.

“In real terms, what that means is that for every four patients we would have admitted to hospital in 2005, we would only admit one today," she said.

She pointed out that the data means there are “only 23.8 adult acute mental health beds per 100,000 population in public approved centres in Ireland, compared to an EU average of 73 beds”.

If Ireland were to aim for that ratio, then the IHCA estimates "the current shortfall is more than double the above HSE estimate at around 1,800 inpatient beds".

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The HSE report recommended aiming for 25 beds per 100,000 population, meaning 164 more beds are needed in the short term.

These shortages, coupled with deficits in staffing and other resources, make it harder for services to keep staff, Prof Doherty added.

On the night beds analysed, staffing levels were at 80% of the 2006 recommendation. 

“It’s very difficult for Irish doctors to decide to come home [from other countries] and, for example, make those very difficult choices of who gets that single psychiatric bed when you have four people who need it,” she said.

Mary Butler, minister with responsibility for mental health, spoke about this report in the Dáil on Wednesday, saying a full review of mental health bed capacity throughout the whole country has been done.

She previously said its recommendations will form part of “an overall multi-year capital plan which covers existing as well as additional facilities and capacity”.