A review by the Mental Health Commission has concluded that there is “an almost total absence” of community mental health services across the State.
It says that the lack of supports like crisis houses, intensive high-support hostels, rehabilitation high support hostels, specialist rehabilitative units and psychiatric intensive care units, is impeding access to acute mental health beds across the country.
The report examined access to acute public mental health beds for adults and is based on the results of an audit of facilities in November 2018.
The commission found that despite gaps highlighted by the 2006 strategy ‘A Vision for Change’, these supports have not been provided in the intervening 14 years.
The review said that as a consequence, the prolonged stays of people experiencing mental illness in acute mental health units is having a significant impact on access to acute beds.
It also found that there was a severe lack of acute mental health beds for older adults.
The audit showed there were 1,050 acute public mental health beds, higher than the recommended 794.
There were 56 beds for older adults, less than the 127 recommended.
The report noted that the acute bed recommendations were based on a full complement of additional specialist and community resources, which have not been provided.
It said that severely unwell people, who should have access to a psychiatric intensive care unit, are instead placed in acute facilities, which consequently upsets the milieu of what should be calm and therapeutic units.
The review said that long-term political and social commitment is needed to ensure the development of a comprehensive range of community and specialist services and this will require ring-fenced funding.
The authors found that while the current provision of public acute adult mental health beds is broadly in line with recommendations in ‘A Vision for Change’, access to these beds, impeded by a lack of specialist resources, is both insufficient and inadequate.
It said that while ‘A Vision for Change’ recommended that 15 intensive care beds be provided, as part of four national combined intensive care rehabilitation facilities, not one unit has been developed.
In response, the HSE said it provides a wide range of community mental supports across the State.
It said that nationally there is a total of 111 general adult community teams and 32 psychiatry of later life teams.
The HSE said these teams support people to remain in their homes and in the community where possible in line with Sláintecare.