Report reveals children with a first episode of psychosis waited a week in hospital A&E

Cork University Hospital (CUH) saw 1,569 mental health patients including 140 children in 2023. File picture: Larry Cummins

A "troubling" new report has led to calls for urgent investment in emergency mental health services, including for children waiting up to a week in emergency departments in hospitals.

Around 51,000 people first seek help for acute mental health needs through emergency departments or medical wards every year, the Mental Health Commission (MHC) report said. However, it warned of “substantial variations” in care between different hospitals or types of hospital.

The need is high at all Munster emergency departments but the report identified gaps, especially in evenings or weekends in smaller hospitals.

Cork University Hospital (CUH) saw 1,569 mental health patients including 140 children in 2023. Another 1,000 mental health presentations happened at the Mercy University Hospital (MUH).

University Hospital Kerry saw 594 patients with thoughts of self-harm or suicidal ideation. It does not record other challenges. In University Hospital Waterford, it saw 1,462 mental health attendances.

However, University Hospital Limerick does not record mental health patients. It told the commission these patients fall under community care.

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Philip Watt, interim CEO of Mental Health Reform, an umbrella group of charities, said emergency departments are often inappropriate for these patients.

“Particularly troubling is the high number of children attending paediatric emergency departments,” he said.

“This reflects inadequate out-of-hours services and under-resourced community mental health supports. These findings underline the further need for sustained and significant investment across the entire mental health sector.” 

The report highlighted a crisis - caused by shortages of child-specific placements – at the Mater Hospital, saying “acutely unwell 16–17-year olds with a first episode of psychosis have been waiting in the emergency department for up to one week”.

Mr Watt said: “Investment in mental health must be a priority for this government in Budget 2026, including in respect of the issues raised in this report." The mental health budget "has stagnated at between 5% and 6%” of the overall budget, despite a commitment for 10%, he added. 

The Irish Nurses and Midwives Organisation (INMO) said the report echoes what its nurses see.

Phil Ní Sheaghdha, general secretary, said: “We know there have been many incidents of children under the age of 16 with acute mental health issues being admitted to emergency departments.

It is not right or appropriate for children who are in mental health distress to be spending up to a week in emergency departments. This is a matter which must be addressed urgently. 

The findings indicate, she said, “overcrowded and understaffed emergency departments are not appropriate places of care for patients with acute mental health issues”.

The Irish Patients Association focused on the impact on people who do not get the right help which the report described as a “so-called revolving door”.

Co-founder Stephen McMahon warned that patients were discharged without a care plan, only to return in distress. "This dangerous revolving door approach is putting vulnerable lives at risk," he said.