The Irish Medical Organisation (IMO) has told the Oireachtas Sub-Committee on Mental Health that the access and continuity of mental healthcare services is under serious threat due to ongoing resourcing and integration issues.

 

In his address to the Committee this morning, Professor Matthew Sadlier, a member of the Consultants’ Committee of the IMO, emphasised that issues of access to mental health care stem from:

• Deficits in manpower and psychiatric inpatient bed capacity;
• Issues with the Governance model for mental health services; and
• The need to adequately integrate mental healthcare into the wider acute healthcare system.

 

Prof. Sadlier reminded the Committee that one-third of psychiatry posts are either unfilled or staffed on a temporary basis, which stems directly from the two-tier consultant pay issue which has been a feature of the health system for eight years.

 

He also referenced the shortage of in-patient psychiatric beds in Ireland. Currently, there are just over 1,000 acute adult psychiatric beds which operate at almost 90% capacity. This is well above the 85% safe occupancy levels. While Covid-19 impacted on the availability of psychiatric inpatient beds, there has been no attempt by the Government or the HSE to increase the provision of acute psychiatry beds or provide emergency alternatives.

 

Prof. Sadlier informed the Committee that because the governance and budget for mental health services come under the Community Health Organisation model, inpatient psychiatric units have become a “hospital within a hospital” with no additional funding to access diagnostics and therapeutic services on the same campus.

 

Overall, there is a greater need to improve the integration of mental health care into the wider healthcare system in order to improve outcomes for patients with chronic and enduring mental illness, who on average die approximately ten years earlier than the rest of the population.

 

The IMO is recommending the following:

• Urgent implementation of measures to address the recruitment and retention of Consultants across our health system – this includes addressing the two-tier consultant pay issue which is recognised as a major barrier to recruitment; 
• Fully resources community and hospital based mental health care teams in line with the recommendations of A Vision for Change;
• Urgently assess the number of acute inpatient psychiatric beds required to ensure timely admission of patients presenting with acute psychiatric illness;
• Address the governance model to ensure inpatient psychiatric units have access to  necessary services on site;
• Appropriately integrate mental health care services into the wider health system;
• Roll out the national patient identifier and the electronic shared care record as per the 2019 GP Agreement. 

Prof Sadlier's opening statement can be read here
The full session can be viewed here