Thursday 17 October 2019

Modern approach to age-old problem


COUNTY Wexford has no facility for acute psychiatric admissions.

As it stands a patient in need of acute psychiatric care must be transferred to either the Department of Psychiatry at Waterford General or Newcastle Hospital, Wicklow.

For generations Wexford patients were able to access in-patient psychiatric care in their home county through admission to St. Senan's Hospital in Enniscorthy.

However, when inspectors from the Mental Health Commission slated the facility describing the Victorian building as 'not fit for human habitation' in its 2010 report it was decided that the best course of action would be to close the hospital.

As of February 2011 St. Senan's has been closed to new admissions.

However, there are approximately 25 long-term patients at the hospital who will remain there until a new facility has been built on the site of the old Wexford General Hospital.

This purpose-built facility has been designed to cater for both elderly patients and a separate section for elderly psychiatric patients.

The closure of St. Senan's is part of a new approach adopted by the HSE in their delivery of mental health services nationwide.

Dr James Reilly, Minister for Health, speaking in Wexford in relation to the closure of St. Senan's said: ' there has been an over emphasis on the past and placing patients in institutions for long periods of time. That is not current practice anymore.'

Certainly this new approach to the delivery of mental health services in a community-based environment has been welcomed.

County Councillor and former nurse at St. Senan's, Pat Cody, believes that this 'major change in the delivery mental health services is well overdue'.

'There has been a need for a move away from the old institutions to a community type service,' he said.

However, he was quick to admit that the funding allocated to mental health falls below the required levels to ensure an adequate service is in place.

'I'm loathed to go into figures but mental health certainly receives the lowest of all sectors of the health service,' said Cllr Cody. 'If it's to be done properly, it should attract proper funding.'

Cllr Cody estimates that there is a need for an additional €35 million. When asked if the people of Wexford could expect to see the same level of funding attracted by St. Senan's when it was open to be allocated to alternative mental health services, the Minister for Health was unequivocal: 'Absolutely, it's very much the case that we want all new primary care centres to have a mental health facility'.

He did, however, offer no projection on the budget for mental health services in Wexford.

The Minister stood over his belief that the closure of St. Senan's was a positive step towards establishing an improved mental health service for Wexford.

It would appear that some people, however, still hope that a new facility for acute psychiatric admissions will be established in Wexford.

On April 5 last, when Wexford town Mayor Davy Hynes announced over the social networking site facebook that a ten bed 'acute care' psychiatric unit was to open in Enniscorthy, his announcement was met with gratitude by constituents.

However, as it transpired this is not to be the case. The ten beds in the pipeline for Enniscorthy will not be equipped to deal with acute admissions.

Mayor Hynes later realised his error and offered clarification on how the unit would actually operate. 'After it was explained a bit better to me, I understand that it will be a short stay respite unit,' he said.

He expressed his assurance that he would continue to lobby for an acute facility for the county.

'We haven't given up on that', he said.

Finding a balance between a shift away from the old style 'over emphasis on institutions' and a lack of acute care facilities is clearly proving difficult.

Future plans for the provision of mental health services in the county, as laid out in the HSE'S most recent report 'A Vision for Change', centre largely on the delivery of psychiatry services in a community care capacity.

There will be a greater emphasis put on the Mental Health Day Centres, which are often the first point of contact for many patients.

'Ninety per cent of the HSE'S work in this area will be carried out in these centres', said Cllr Coady.

These major changes in the mental health service will run in tandem with the 'total' closure of St. Senan's.

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