Psychiatrists call for ‘radical overhaul’ of mental health services in Ireland

Psychiatric services in Ireland require a “radical overhaul”, especially for children and adolescents, the College of Psychiatrists of Ireland has said.

There is a crisis across the entire psychiatric system including in child services, prisons and mental health beds, leaving the provision of services in a “dire state”, president of the College of Psychiatrists of Ireland Dr William Flannery has said.

Lengthy waiting lists for mental health beds mean patients are ending up in the emergency department “which really is just not right”, Dr Flannery said.

“We cannot continue with this underfunded, under-resourced, underappreciated service,” Dr Flannery told RTÉ Radio’s Morning Ireland.

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“I would have very serious concerns about any service — whether child or adult — that does not have a fully trained, fully competent consultant psychiatrist in position. What is so frustrating for those families or individuals applying for services, is to navigate through the system. That is why we are calling for such a radical overhaul.”

There had been several crises in mental health services with “several thousand children” who had been referred by their GP for urgent care effectively being turned away, he said.

“This is on the back of a crisis that started at the beginning of the year around the resourcing of these services and how they’re run. It’s not only child services, it is across the system.”

Dr Flannery pointed out that there had already been one report about the “neglected state” of mental health units, which came after years of underfunding and under-resourcing. The College of Psychiatrists had warned of this issue repeatedly, the consequences of which were now being seen.

There were two solutions, he said. The first aspect was funding which needed to go from 5.6 per cent to “at least 12 per cent”. The second area was governance and oversight.

“We need to put people in charge to join up the system, to ensure there is a radical overhaul — all this is already in the Programme for Government and this is what is so frustrating.

“We’re calling for a reinstatement of the director of mental health in the HSE, there has to be a chief psychiatrist in the Department of Health and given what we’re seeing recently once again in child services, we’re calling for national clinical lead for child psychiatric services.”

Now is the time to act on a further report on consultant recruitment and retention, he added.

“According to the workforce planning report more than 20 per cent of consultant psychiatrist posts are either not filled or inappropriately filled — the question is who are going to fill them?

“What the college is advocating is to train more doctors who wish to become psychiatrists. We are allowed to take in 80 per year, but we know at the last recruitment stage we could take an extra 20 and this needs to be supported by adequate funding — we know that training costs — €1.9 million — but €1.3 million is only allocated for it.”