By Catherine Finnegan
Almost half of all beds in the Linn Dara, Child and Adolescent Mental Health Unit in Cherry Orchard are closed due to staff shortages. The HSE has confirmed that 11 of the meagre 23 beds will be closed until at least September. The Psychiatric Nurses Association (PNA) has strongly condemned this move by the HSE, pointing to a similar decision made in 2017 highlighting that little has been learned in the intervening years.
It is recommended that 100 beds be available for children and adolescents requiring mental health treatment and this move means only 56 will be available. A consequence of this will be that an increased number of children and adolescents requiring specialised mental health care will be forced into adult mental health units which simply cannot provide the care that these young people need.
The in-patient unit in Cherry Orchard requires a staffing of 51 nurses and there are currently only 24. This shocking level of staff shortage is not an anomaly but rather becoming the norm across the health service. There is a severe recruitment and retention crisis in the health service as chronically overworked and under-paid health care workers seek to emigrate for better pay and conditions, which in turn exacerbates the pressure and poor conditions faced by the workers who cannot or choose not to emigrate.
As young people have had their lives hugely disrupted by the pandemic and are facing continuous bleak reports about the economic and climate crisis, it is hardly a surprise that mental health problems are increasing. Other issues that affect society have profound impacts on children and young people who may feel more helpless and overwhelmed. Young people in schools are sharply aware of issues like discrimination and inequality, and many are actively dealing with the impact of the housing crisis and living in emergency accommodation.
The Irish Times reported in 2021 that there were 2,000 children and young people awaiting CAHMS (Child & Adolescent Mental Health Service) and 10,000 awaiting primary care psychology, the majority of whom are children. It is simply impossible for these disgraceful waiting lists to be reduced while beds are being closed. Of course the staffing crisis in the health service is nothing new, and yet nothing is being done about it.
Public investment is crucial
We need to put time and resources into mental health education in schools, relieving pressure on the health system and providing help to children and young people before their mental health deteriorates to a point where medical intervention is necessary. At the same time the budget for mental health services must be significantly increased – just €37 million was allocated in Budget 2022 to deal with this major societal crisis.
Mental health centres that are open 24/7 must be established, professionally staffed and fully resourced in all communities. The healthcare workers, the community groups and those who use these services must have oversight and input into how the services are run. Young people should not be reliant on the private sector for counselling services, which are generally unaffordable. They should be easily accessed as part of a public national health service, free at the point of use.