Call for 24hr mental health A&E in Nenagh
By Brendan Murphy
‘OUR mental health is a state of well-being that enables people to cope with the stresses of life, realise their abilities, learn well and work well, and contribute to their communities’ – World Health Organization
If you cut your hand and need help, your first line of thought is to head to the A&E department, yet if you are experiencing a mental health crisis and need urgent assistance there is no 24-hour walk-in service available where you can get the help you need – and this needs to change!
Mental health affects everyone and I think people can sometimes forget that. Life can be challenging and unpredictable and in truth none of us know from one day to the next when we might find ourselves in difficulty with our mental health. Financial pressures, anxiety, stress, job related pressures, the loss of a loved one and loneliness are just some of the day-to-day challenges that many of us face that can no doubt have a negative impact on our mental health.
LOCAL ORGANISATIONS
We have many great organisations, most of which are run by amazing volunteers but there is only so much that they can do. Locally we have C-SAW Tipperary, who provide services two evenings a month and provide a phone service for those that need it. Pieta House also provides a 24/7 phone service – both of which provide counselling; these services are vital but there are still serious gaps in the system as not everyone is going to avail of this type service, especially for extreme and serious cases where someone is in the midst of a personal mental health crisis. They need to go somewhere where they can be seen and treated within a safe environment where the risk of self-harm is reduced or removed.
In Nenagh we have Dromin House Mental Health, who provide mental health services run by the HSE. Dromin house generally work on a referral basis - according to the staff working there. I contacted Dromin House and I asked the following question: “If someone were to present themselves to Dromin house in need of mental health care without a referral, what would happen?” The staff member said that they do their best to look after everyone who walks in the door, however, they are not guaranteed that there would be a doctor on site if a case like this did arise - and there lies the problem.
Services like Dromin House are under resourced and underfunded and this is creating a huge gap in the system. The dedicated staff can only work with the resources on hand. Because of this, we currently have waiting lists of six months or more for patients looking for counselling services.
Can you imagine if you were in mental distress and needed help, how it would feel to be turned away? Or told you must wait at least six months to talk to a counsellor? There is no provision in place to cope with the demand that exists, the current system is not fit for purpose and this needs to be addressed.
TIPP'S HIGH RATE OF SUICIDE
Tipperary has one of the highest rates of suicide per population. Between 2019 and 2022, 83 people took their own lives. 70% of those were male (CSO figures).
In a recent Spotlight report the percentage of young people between the ages of 18-25 who have self-harmed rose from 21% to 38%. In addition to this the percentage of young people aged 19-25 who thought about taking their own life rose from 51% to 63%.
These are worrying statistics as all the trends are on the increase, yet we are not seeing any significant plan from Government to address what can only be described as a crisis. In 2021, there were 512 recorded deaths by suicide in Ireland, 80% of these were male (CSO Suicide Statistics).
I am calling on our local elected representatives and indeed the Government to consider the establishment of a 24-hour mental health A&E service to be piloted in Tipperary with the view to rolling this out nationally. The former St Conlon’s Nursing Home could well be viewed as a potential location for such a service in Nenagh.
NON-REFERRAL SERVICE
In northwest London people have access a walk in Mental Health Crisis Assessment Service – without referral. This service offers a calm and therapeutic mental health setting to treat the majority of emergency mental health presentations.
The unit will see and assess anyone over the age of 18 that would otherwise go to a traditional A&E department for mental health reasons and that do not have an urgent medical need (for example - overdose of medication). The service offers full emergency mental health assessments and onward care planning in the department with a diverse and highly skilled workforce incorporating nurses, doctors, and support workers.
This is the sort of services that we need in Ireland.
The current structure and level of service is simply not working and it is time for a fresh outlook and a new approach. If we are serious about addressing and reforming our mental health services, we need to invest in the current services that we have but we also need to add additional services to fill the gaps that currently exist.
A 24-hour mental health A&E might seem a bit extreme to some people but, given the sobering statistics in relation to suicides in Ireland alone, the idea of such a service is more than justified, particularly if it can potentially save lives.