Fears for psychiatric service

Fears have been expressed that services for psychiatric patients throughout Clare could be reduced next week if a nursing union proceeds with its threat to withdraw from working overtime in the Clare Mental Health Service.

Members of the Psychiatric Nurses’ Association (PNA) have voted to cease the practice of working large amount of overtime due to ongoing chronic staffing shortages in the Clare Mental Health Service.
According to a Nurse Management Contingency Plan, between 15 and 17 whole-time equivalents are being used in nursing overtime every week and despite this, some units remain short staffed.
The plan makes a number of recommendations including redeploying staff from crisis centres, day centres and other community services, termination of respite provision in Cappahard and reduction of beds in acute units.
Long-term plans include closure of Orchard, Kilrush, the closure of the acute psychiatric unit, transfer of clients to alternative care settings, reorganisation of day hospitals to reduce admissions and decisions on sector alignment.
PNA spokesman Denis Meehan claims the union has consistently asked the HSE to recruit new staff to fill shortages and have argued it would cost less and new entrants would be on a lower grade.
Mr Meehan is seeking additional funding for the Clare Mental Health Service and a lifting of the national recruitment ban, which is crippling the service.
He says unions are opposed to the removal of the crisis service, where one member of staff was on duty from 4.30pm to 3.30am to deal with acute emergencies or people who were extremely depressed and displaying a number of symptoms, including suicidal tendencies.
He says that at this time of night the risk of people dying by suicide is at its greatest and its removal would be a retrograde step.
He claims it is possible that a day hospital such as Shannon Day Hospital may have to close for a day if enough staff are not available.
“If people can’t get services in the community, they may end up in hospital or in the acute psychiatric unit. The whole concept of the Vision for Change was to provide services in the community and move away from institutional-type care.
“People who have a wide range of mental-health issues such as schizophrenia and biopolar disorder are being successfully managed in the community with support from day hospitals and staff working in the community.
“If patients with these types of conditions don’t get proper care, they could end up in the acute psychiatric unit, which is already full. The respite provision of three beds in Cappahard provides a valuable service for families who are caring for an Alzheimer’s patient.
“The staffing issue in the Clare Mental Health Service has been an ongoing problem. It has been discussed at LRC level but there still hasn’t been a solution,” he said.
Deputy Pat Breen recently asked Health Minister Mary Harney to outline the numbers of people employed in the Clare Mental Health Services in a Dáil question.
He was told by the HSE that the number of funded whole-time equivalents (WTEs) was 214.77 in 2008, the actual number was 201 and there were 13.44 vacancies that year.
This year the number of funded WTEs was 186.90 and the actual number was 167.99, leaving almost 19 vacant WTE posts.
The Mid-West HSE confirmed it has met with PNA and SIPTU staff representatives to discuss the position arising from the PNA’s threat to withdraw from all overtime working in the Clare Mental Health Services from August 23. 
“At this meeting, management put forward a contingency plan for the ongoing maintenance of essential services in the event of a complete withdrawal of overtime by staff.  The unions’ response is awaited,” said a HSE spokesman.