MENTAL HEALTH services are in “free fall” at a time when the demand for services was never greater, according to the Psychiatric Nurses Association (PNA).
In a report prepared for the HSE and the Minister for Health, the union says this is because of the huge numbers of psychiatric nurses retiring who are not being replaced due to the moratorium on recruitment and due to the small proportion of the health budget being spent on mental health in Ireland, where at 5.3 per cent of the overall health budget it is less than half the 12 per cent spent in the UK.
At the same time demands on the service are increasing, with rates of suicide going up and numbers presenting for treatment of deliberate self-harm rising.
It says 596 psychiatric nurses retired last year, and this has resulted in large numbers of posts remaining vacant. Costly agency nurses were in some instances being used to fill gaps “pushing services over budget, leading to further cutbacks”, while in other instances “security companies are being employed” to care for patients.
It says in tandem with increasing numbers of vacancies, assaults on staff are rising.
Some 1,314 assaults on staff were recorded last year, up from 966 in 2007 and 1104 in 2008. On one occasion eight gardaí in riot gear had to come to the assistance of nurses trying to manage a highly-aggressive patient.
The PNA says it is satisfied the need to employ security personnel and the increasing need to call for Garda assistance is not just related to an increasingly violent society but to shortages of staff and reduced access to secure facilities.
Giving examples of recent incidents, the report says: “On Sunday night last a patient set fire to part of the acute unit in Tallaght Hospital. A number of nurses were injured in the evacuation of patients with burns and smoke inhalation.
“A week earlier a patient, transferred from Cloverhill prison, broke his way into the ceiling of the acute unit in Tallaght Hospital and accessed electric wiring which he wrapped around himself. When nurses got him down he was threatening and assaultative.”
Des Kavanagh, general secretary of the PNA, said psychiatric nursing must be exempt from the recruitment moratorium. “Staff shortages are contributing to unsafe and unsatisfactory experiences for patients.”
A recent report prepared by HSE West also found there had been an increase in the number of violent incidents in the mental health service “partly as a result of the low staffing levels and inexperienced staff”.
The Department of Health said the 2010 Employment Control Framework provided for an exemption from the moratorium for the filling of up to 100 psychiatric nursing posts where they were required to support the implementation of A Vision for Change, the blueprint for modernising mental health services.
The HSE said the moratorium had created a significant challenge but it had been working with the Department of Health and had received a Government exemption from the moratorium targeted at the replacement of 100 psychiatric nurses this year.