Hire more psychiatrists or new vision remains ‘aspirational’, warns IHCA

The new mental health policy does not address the shortage of consultant psychiatrists in Ireland and is doomed to fail, according to the Irish Hospital Consultants Association (IHCA).

Launched yesterday, ‘Sharing the Vision — a Mental Health Policy for Everyone’ was hailed by Minister for Health Simon Harris as a “policy for everyone”.

The IHCA, however, dismissed the document as “aspirational” and said it has failed to address real pressures on the system, such as the number of consultant psychiatrists in Ireland being half the European Union average.

The policy it is replacing — the 10-year ‘Vision for Change’ plan published in 2006 — was never implemented fully, the IHCA added, and this new strategy was likely to suffer the same fate.

IHCA President Dr Donal O’Hanlon also warned staffing and bed capacity deficits would continue, resulting in significant access problems to acute psychiatric services.

“The new mental health policy has failed to set out the urgent workforce requirements needed to staff a modern psychiatric service,” he said.

“The Mental Health Services must recruit the required number of consultant psychiatrists, a near doubling in the current number, and other staff prescribed by the previous policy ‘A Vision for Change’ and a plethora of other expert reports.

“This requires the filling of all consultant psychiatrist posts on a permanent basis. We simply do not have the resources and the number of consultant psychiatrists required to provide high quality, timely care and treatment to patients who need it.”

The problems in mental health services which, according to the IHCA, the previous policy failed to address include poor staffing levels, with Ireland having 6.1 consultant psychiatrists per 100,000 population — below Romania, Slovakia, and Greece. Other problems include declining inpatient psychiatric bed capacity, which has fallen from to 34.83 beds per 100,000 population from 101 bed in 2004; and capacity deficits in the Child and Adolescent Mental Health Services (CAMHS), where only three-quarters of the 74 available CAMHS beds are open at any one time.

Meanwhile, the percentage of children or adolescents offered an appointment and seen by the CAMHS Team within 12 weeks was 3.6 per cent below target nationally in September 2019. Also, the percentage of older patients offered an appointment and seen within 12 weeks by the Psychiatry of Later Life Team was 2.3 per cent below target nationally (95% target) in the same month.

Stressing that funding for mental health services needed to increase in order to deliver quality of care envisaged by the new policy, Dr O’Hanlon added the new policy failed “to set out the urgent workforce requirements needed to staff a modern psychiatric service”.

“We simply do not have the resources and the number of consultant psychiatrists required to provide high quality, timely care and treatment to patients who need it,” he added.

Meanwhile, the Psychiatric Nurses Association (PNA) said the fate of the policy hinged on engagement with stakeholders, including the PNA.

“PNA will have a detailed, comprehensive appraisal of ‘Sharing the Vision’ for the new incoming Minister as part of the next Government,” PNA General Secretary Peter Hughes said.

“We look forward to a full engagement on the implementation of ‘Sharing the Vision’ to deliver on the promises of reform of our mental health services.”

peter.doyle@imt.ie