No patients are being accepted into mental health day services or the home based treatment team as a result of the loss of psychiatric consultants to mental health services in the county.
The ‘embargo’ has been ordered by HSE senior management because one consultant has left and another is on extended, planned, leave.
The Psychiatric Nurses Association (PNA) is warning of serious cutbacks in services as a result of the shortage of consultants and junior doctors in the South Tipperary Mental Health Services.
Paschal Burke, PNA branch chairman in South Tipperary, says the community services being cut were developed in line with the ‘Vision for Change’ strategy following the closure of St Michael’s in patient unit in Clonmel. “The cuts being demanded now fly in the face of the commitments to community psychiatric services under Vision for Change,” Mr Burke says.
As a result of the present situation no person will be accepted to the Home Based Treatment Team or in Crisis House from either the Tipperary Sector or Clonmel West Sector. No client will be accepted or discharged from Day Services. No appointments will be offered for routine referrals.
All out-patient clinics had to be cancelled, affecting 60 clients so far in the Tipperary sector alone. There is also the potential that the out of hours on call assessment, through the A&E Department of South Tipperary General Hospital, could be cancelled.
The South Tipp area is divided in to three sectors for mental health services - there is no permanent consultant in the Tipperary area. A locum was appointed last week but will only be there for two weeks. While all team members do continue to carry out their roles without a ‘clinical lead’ in the team decisions for patients can not be made.
According to Mr Burke clients continue to be discharged from the Department of Psychiatry (DOP) with discharge plans but these plans are not feasible if there is no consultant.
The DOP have been informed but continue to make plans that include home based treatment, out patient clinics or day service follow up. The restrictions will lead to delayed discharges in some cases and this will result in beds being blocked and impacting on their availability to acute presentations, Mr Burke highlights.
He does pay tribute to the Trojan efforts being made by the HSE to recruit consultants. It is the general pay and conditions being offered to consultants in Ireland that can not compete with other countries.
Since the closure of St Michael’s in Clonmel patients were offered assessment, treatment and support in their community with services including: care in their own home, in day hospitals in Clonmel or Cashel; referral to Day Centres in Tipperary or Clonmel; support in Crisis House in Clonmel or admission to the Department of Psychiatry in Kilkenny.
“The lack of consultant psychiatrist cover has grave implications for the provision of all of these services. Once again a lack of planning by management has resulted in emergency decisions being made without consultation and with serious implications for patients and their families throughout South Tipperary,” according to Mr Burke.
“South Tipperary is lauded across the country as the service best mirroring Vision for Change strategy and other services throughout the country have sought to emulate the progress here. Unfortunately all of that good work is now being seriously compromised due to the lack of consultant psychiatrist cover.”