When disturbed and violent male patients present at Dublin's main hospitals for treatment, there is nowhere to accommodate them, it was claimed yesterday.
This follows the closure of almost half of all the secure beds for such patients. They had been available at Dublin's St Brendan's Hospital.
At least 10 of the 24 secure beds in the hospital have been closed recently. The Health Service Executive said last night this was because it had difficulty finding the male nursing staff required to staff the beds, despite recruitment campaigns both nationally and internationally.
Dr Patricia Casey, a consultant psychiatrist at the Mater hospital, said the closure of the beds was a very worrying development as there were now no secure beds to send very disturbed patients to who cannot be accommodated safely in an open ward.
The remaining secure beds in St Brendan's are occupied by long-stay patients, and while the HSE could in theory pay to subcontract intensive care beds from one of two private psychiatric hospitals in Dublin, these are usually not available, she said.
Dr Casey said the secure beds in St Brendan's had been reduced gradually over the past year or so but the latest closure of beds was "the last straw". She said it had serious implications in terms of the safety of other patients in open wards, staff and the public.
Furthermore, she said the HSE's own Vision for Change policy stated that each of the four HSE regions should have a 30-bed intensive care unit for patients with difficult to manage behaviour.
Des Kavanagh, general secretary of the Psychiatric Nurses' Association, said the closure of the beds was typical of the neglect of the mental health services for many years. "Today we are now far worse off than we have been in many years as the available beds have been halved and access for new patients is no longer possible," he said.
He said that since January 2006 some 90 patients were transferred to secure beds in St Brendan's from other Dublin hospitals and this indicated how important they were. It is understood one disturbed person who recently appeared before the courts required a secure bed in St Brendan's but when none was available he was released on bail.
The HSE, in a statement, said that in the interests of health and safety it had reduced the number of male secure beds in St Brendan's as there weren't enough male nurses to staff the beds. It stressed 14 secure beds for male patients remained open.
"A new, modern, purpose-built psychiatric intensive care unit and low secure unit will be provided as part of the Grangegorman development. This . . . development will be very conducive to attracting the staff required to provide the services. The building work is due to commence in 2009," it added.