HSE pledges Crisis Intervention Service retention

THE Mid-West HSE has rejected claims it is planning to reduce the Crisis Intervention Service, which helps people experiencing suicidal thoughts or those at risk of engaging in acts of self-harm.

The Psychiatric Nurses’ Association (PNA) made a claim that psychiatric patients would be affected by a threatened reduction in the HSE-funded Crisis Intervention Service.

The HSE, however, insists the Crisis Intervention Service will continue to be available. Should a crisis intervention nurse not be available for any reason, the HSE stated the service user will either be seen by staff of the Clare Mental Health Services, such as an on-call doctor, or there will be other appropriate measures put in place from time to time.
“The HSE does not accept that even in constrained financial and recruitment circumstances, that we would knowingly take any action which would cause risk of death to any person and we consider that the statement by the local PNA rep to be highly inflammatory in this regard.
“Whenever staff are not available or reduced, the local clinical management make appropriate decisions to prioritise services. It should be noted, in particular, that the Clare Mental Health Services has utilised a significant amount of agency nursing staff in the current year.
“While there are no plans to place the crisis intervention service in the hands of Shannondoc GP out-of-hours service, the Shannondoc service is available out of hours for all people, including those who may experience a mental-health issue. There is an ongoing working relationship between Clare Mental Health Services, Crisis Invention Services and Shannondoc,” a HSE spokeswoman said.

The PNA’s concerns are shared by the Emotions Peer Support Services Centre in Ennis, which urged the HSE to make the well-being of those in need a priority, rather than use them as “financial pawns” to balance national budgets.

Psychiatric patients and those suffering from mental health illness or depression can contact a Crisis Intervention Nurse, seven days a week, from 4.40pm until 3am.
Based at the acute psychiatric unit of Mid-Western Regional Hospital Ennis, the highly skilled clinical nurse manager has dealt with an average of eight calls at night, and sometimes up to 14, since it was introduced in 1999.

Clare Psychiatric Nurses’ Association representative, Denis Meehan, warned this nurse may not be available this weekend and may also be unavailable next week due to chronic staff shortages, cost containment measures and the national recruitment ban. Previously, there were two PNA nurses rostered for this service and when one went on holidays, another nurse was drafted in to provide cover.

Mr Meehan claimed there was a derogation obtained by local management from the national recruitment ban for four new permanent PNA nurses and 10 temporary staff to cover shortages in Clare Mental Health Services but this was stopped at the 11th hour pending a review.
He called on Health Minister James Reilly to allocate the necessary funding to continue the crisis nurse and fast-track the hiring of new staff.
He also asked that Minister Reilly lift the national recruitment embargo to allow the Mid-West HSE tackle staffing shortages in the mental-health services, where the whole-time equivalent staffing complement has fallen from a high of 214 in 2009 to 136.

In a statement to The Clare Champion, Liam Minogue of the Emotions Peer Support Centre pointed out the purpose of this nurse is to provide a “gate-keeping” role to reduce the number of inappropriate admissions to the acute psychiatric unit attached to the hospital.
He noted this service can provide an enhanced psychosocial assessment and intervention for those presenting with mental-health problems to the emergency department, particularly during the after-hours period.

It is also designed to provide enhanced liaison between stakeholders providing mental-health services in the area such as day hospitals, GPs, homeless services and social work services.
“Unfortunately, due to budget restraints, it is our understanding that this service shall be placed under the responsibility of the Shannondoc services,” he claimed.
“Are the staff of Shannondoc trained in crisis intervention? Will they have the needed time to offer proper support to those who avail of the service?
“At present, the staff of the acute unit would have a good knowledge and relationship with many of those who use this service and the support they provide is invaluable.
“The centre urges the HSE to put the well-being of those in need as a priority and not to be used as financial pawns to enable them to balance their budgets,” Mr Minogue stated.

A spokesman for Minister Reilly hadn’t responded to a number of Clare Champion queries at the time of going to press.