IMO GPs warn on Covid 19 and Mental Health issues
The IMO has told the Oireachtas Committee on Mental Health that it believes that Covid 19 has had significant psychological effects on people across the country.
Dr. Denis McCauley, Chair of the GP Committee of the IMO and Dr. Sumi Dunne from the GP Committee were addressing the Oireachtas Committee on the impact of Covid 19 on the demand for mental health care and access at Primary Care level.
The two GPs told the Committee that there was growing incidence of common mental health problems and more marked neuro psychiatric disorders associated with the Covid 19 pandemic; “these can arise from direct effects of infection and of long Covid syndrome with enforced isolation and quarantine and with additional stressors arising from abnormal bereavement, job losses, inter familial tensions or sudden impoverishment. They can present as acute psychiatric diagnosis or an exacerbation of previous issues including domestic violence or increased alcohol or drug use.”
The IMO GPs criticised the lack of funding for mental health in General Practice despite the fact that up to 90% of mental health issues are manged in General Practice without referral to specialist mental health services. In addition access to publicly funded counselling and therapy services in Primary Care is poor.
Dr. Dunne warned that the incidence of mental health disorders in children and adolescents is growing with studies showing that as many as 1 in 6 young teenagers show evidence of diagnosable mental disorders however specialist child and adolescent mental health services are equally under resourced. As a result 2,229 young people with serious mental health and behavioural problems are on a waiting list for an initial assessment with a CAMHS team with over a third waiting longer than 6 months.
Dr. McCauley warned that failure to appropriately resource mental health care in General Practice and to provide adequate counselling and psychotherapy services in primary care can lead to an over-reliance on drug therapy. At the same time failure to adequately resource specialist mental health services in the acute sector means that for many patients the only way to access services is through emergency out-of-hours services or through already stretched Emergency Departments.
The IMO told the Committee that the IMO recommends:
- Investment in a clinical programme of care for mental health should be negotiated between the IMO, the Dept of Health, and the HSE similar to the chronic disease management programmes funded in the recent GP agreement.
- Investment in publicly funded counselling and psychotherapy services and supports in the community, accessible on GP referral; - many practices have available rooms, which could facilitate these services and would de-fragment the management of mental health conditions;
- Appropriately resource specialist child and adolescent mental health services (CAMHS) to ensure timely access for vulnerable young patients;
- Address the difficulties in recruiting and retaining consultant specialists across the health system;
- We must build our capacity in both the primary care and acute settings in tandem.