Acute Mental Health in North Dublin – Concerns by Cllr McGuire

That the HSE report on the Acute Mental Health services for North
Dublin having regard to the 50% reduction in the number of acute
psychiatric beds from the current 48 beds to 24. With this in mind,
will the HSE outline where persons who are seeking psychiatric
in-patient treatment will be accommodated and where emergency
psychiatric beds will be provided noting that all the other mental
health facilities are operating to maximum capacity? Also will the
HSE indicate how the crisis intervention unit is to be staffed
considering the non filling of posts in the public service?

Does this
mean that Planning for the Future and the Vision for Change strategies
for the Mental Health services no longer apply?

Submitted by Cllr. Gerry McGuire

Response:

The Mental Health Commission imposed the following condition to the
registration of the Acute Admissions Unit, St. Ita’s Hospital as an
approved centre:

‘requires the permanent closure of Acute Unit Male and Acute Unit
Female in St. Ita’s Hospital – Mental Health Services by no later than
18th September 2011’.

North Dublin Mental Health Services [NDMHS] submitted the following
proposal to the Mental Health Commission [MHC] which details where the
care and treatment will be provided to residents of the Acute Unit
Male and Acute Unit Female following the closure of the units no later
than 18/09/2011.

The NDMHS is using a vacant 25 Bed Unit and Day Service Space at the
Community Nursing Unit, St Vincent’s Hospital, Fairview and use a 6
bed Psychiatry of Old Age Unit in Connolly Hospital for a period of 6
months.

The MHC approved both of these facilities as approved centres for the
period requested on 12th September 2011.

It is accepted that the NDMHS will have to manage within the
allocation of 30 Acute beds [24 general (1 bed to be used for
seclusion) and 6 Psychiatry of Old Age] and that there will be
challenges to manage the acute admissions for North Dublin, with this
reduction in acute beds.

To assist with this reduction in beds, the RDO has written to all Area
Managers in Dublin North East and requested that all Mental Health
teams have access to all acute beds in HSE Dublin North East in
emergency situations. This is but a reinforcement of current practice
whereby Consultants contact each other when an acute bed is not
available in their own approved centre.

The Executive Clinical Directors have been requested to engage rapidly
to develop a protocol which should be followed in such situations. The
Executive Clinical Director North Dublin will convene this group.

A new out-of-hours nursing service has also been put in place. This
will operate from Swords and Coolock and will be available from 5pm to
8pm, Monday to Friday and from 10am to 6pm Saturdays, Sundays and Bank
Holidays.

It is further proposed to refurbish the existing Admissions Unit at
St. Ita’s Hospital to meet the standards set out by the Mental Health
Commission. The NDMHS will re-apply to the MHC to have the newly
refurbished acute admissions unit, re-registered as an Approved
Centre.

This will result in a unit containing 38 beds, 32 for General Adult
Psychiatry and 6 for Psychiatry of Old Age. This unit will operate
subject to registration with the Mental Health Commission until such
time as the new Acute Admissions Unit at Beaumont Hospital is built
and commissioned.

“A Vision for Change” 2006 and Planning for the Future 1984 recommends
that future acute inpatient admissions unit should be located on the
site of a General hospital to ensure patients have access to a wide
range of services. A new purpose built acute inpatients admissions
unit is currently being developed at Beaumont Hospital and planning
permission has been approved, contracts are signed and construction
work is due to commence shortly. This new unit is expected to be
fitted out and ready for occupancy in 2013.

There are currently no immediate plans for a Crisis Intervention Unit
within the Mental Health Services, North Dublin.

Pat Dunne,
Area Manager – Dublin North,
Health Service Executive.

Tel: (01) 8908711
E-mail: pat.dunne@hse.ie