New report identifies shortfall of acute mental health beds in Cork

CORK and Kerry are short between 173 and 368 acute psychiatric inpatient beds to meet recommended levels, with staffing at less than half what it should be in one sector, according to an analysis of figures seen in an unpublished report by the HSE.

The report, which was obtained by the Irish Hospital Consultants Association under the Freedom of Information Act, shows an immediate shortfall of 830 psychiatric beds nationally. 

In 2018, the Joint Oireachtas Committee on the Future of Mental Health Care recommended the number of acute psychiatric beds in both public and private mental health facilities should be increased to 50 per 100,000 by 2021-a deficit of around 1,355 acute beds against current levels.  

However, the HSE report states that given there are 523 private psychiatric beds nationally, the shortfall in public acute psychiatric beds is 832.

The report is the work of an Acute Bed Capacity Specialist Group established by the HSE in 2021 to make recommendations on bed capacity in the mental health services. 

The Group had in its report recommended a phased increase to an initial 25 beds per 100,000 population.

With a population of 690,575, the CHO 4 HSE region, which is made up of both Cork and Kerry, has 171 acute beds, representing 24.8 per 100,000 population.

This means that the Cork/Kerry region should have 344 beds to meet the committee recommendations or 502 beds to meet the European average of 73 beds per 100,000 population.

Despite the high number of beds, CHO 4 had the highest occupancy rate for high-support beds in Ireland, at 93%.

The unpublished HSE report confirms that on the census night in September 2021, staffing levels nationally were considerably below the target recommended in the 2006 mental health policy A Vision for Change.

With 1,552 mental health staff, Cork and Kerry had 87% of the staff recommended in the A Vision for Change policy, and the report notes that additional staffing support is being employed via agency and overtime payments to reach 94% of the same policy recommendations. 

Of the 1,552, some 217 were employed in the community adult mental health sector, representing 75% of policy recommendations for that area.

The region had just 64.3% of the recommended Camhs staff with 95.4% employed in the sector, and only 41.1% of the recommended staff for Community Psychiatry of Later Life — the lowest percentage in Ireland.

As the HSE has used population data from the 2016 census in its report, the true deficits are greater still, given the growth in population — in the 2022 census, the CHO 4 population grew by 50,039 — meaning that an additional 25-37 beds would be required.

Professor Anne Doherty, IHCA vice president and consultant liaison psychiatrist, said: “In 2005, there were 4,000 acute mental health beds in Ireland. That number has now decreased to around 1,100.

“What that means is that for every four patients we would have admitted to hospital in 2005, we would only admit one today.”