Staff shortages in mental health services 'putting people at risk' in Cork says TD

STAFFING presents a huge challenge to mental health services in Cork, with some people at risk of “deterioration or even death”, Social Democrats TD for East Cork Liam Quaide has claimed.

Mr Quaide, who worked as a clinical psychologist prior to his recent election to the Dáil, told The Echo: “We often hear about the complexity of reforming our health services. However, some of the central problems are quite straightforward to address.

“We cannot expect services to be fit-for-purpose if HSE management are restricted from hiring enough staff to run them.”

He said the official recruitment embargo was lifted in July 2024, but was replaced by the Pay and Numbers Strategy, which he claims “has been almost as restrictive”.

Each level of mental health service provision needs to be properly resourced so that shortfalls are not impacting at other levels, he said, explaining: “The failure to resource primary care is putting young people with mild mental health difficulties at greater risk of requiring Camhs [Child and Adolescent Mental Health Services].”

A spokesperson for the HSE told The Echo: “Our priority is always the care and wellbeing of our service users and we wish to apologise to anyone who is struggling to access services, or who is waiting to be seen.

“We are working to address shortages caused by ongoing recruitment challenges, with each team progressing plans to fill vacancies as soon as possible, within the remit of the Pay and Numbers Strategy.

“We are actively recruiting based on clinical need and priority for 2025. The senior leadership team, as part of the post prioritisation process, are reviewing all vacant posts with a particular focus on services which have long waiting times.”

They also said that Cork Kerry Community Healthcare “regrets the lengthy waitlists for primary care psychology services”, saying that a 60% increase in referrals between 2021 and 2024, the recruitment embargo, and other recruitment challenges have contributed to this, but added that an increase in academic places and student sponsorship has improved the staffing situation.

While Mr Quaide welcomed that a number of primary care psychology posts were advertised for Cork in October and November, he said a much more extensive recruitment drive is needed “to address the fact that there are now thousands of young people waiting for those services”.

He continued: “Some client groups are at grave risk of deterioration or even death in the absence of proper treatment.

“We need to see the HSE’s Model of Care for Eating Disorder Services funded and implemented in full, including the provision of four regional Eating Disorder teams and 24 inpatient beds nationally for adults, as well as eight national inpatient beds for young people in the National Children’s Hospital.”

On eating disorder services, the HSE said that the Adult Eating Disorder Regional Service for Cork and Kerry opened in January 2024 and began taking referrals from GPs in March 2024, and “a steering group is in place to support the service and we continue to review referrals and service activity in line with the needs of the population and the model of care”.

As a TD, Mr Quaide will have a particular focus on vulnerable groups of people who require intensive support and fall between services, “sometimes with tragic outcomes”.

He said: “It is a national scandal that some people with an intellectual disability end up languishing in psychiatric wards due to a lack of specialist residential services.

“Others are living in precarious circumstances in the community where they may be at risk of exploitation, or with ageing parents who are unable to cope.

“We need investment in specialist residential services for people with co-existing mental health difficulties and an intellectual disability,” Mr Quaide said

However, a HSE spokesperson told The Echo: “Cork Kerry Community Healthcare (CKCH) Disability Services are not aware of any person with a disability currently inappropriately placed in a mental health service.

“CKCH are aware that, on occasion, people remain in an acute mental health service for longer than would be medically necessary where the person cannot, for various reasons, return to their previous living situation.

“In those cases CKCH work to ensure the appropriate supports are put in place as soon as possible to enable people to move to a more appropriate setting.

“In line with national policy, people with disabilities are supported to live ordinary lives in ordinary places.”

Mr Quaide is also appealing to the HSE to reconsider their proposal to invest over €64m building a centralised residential service for people with severe and enduring mental health difficulties on the grounds of St Stephen’s Hospital, Glanmire.

“When I joined the North Cork mental health services as a psychologist in 2013, the rehabilitation and recovery team had helped many long-stay patients of St Stephen’s to re-integrate in the communities of Kanturk, Mallow, and Fermoy,” he said, adding that these services remain an exemplar.

“The new St Stephen’s proposal is entirely at odds with that progressive trend and with national mental health policy.

“It will lock in vast amounts of public money to a centralised, isolated service that should be spent on community-integrated settings in towns such as Cobh and Clonakilty, where currently none exist.”

He added that there has also been no movement on the new build on the grounds of the Owencurra Centre since the HSE received planning permission in February 2024, which he said was “inexplicable and cannot be attributed to concerns about flood risk, which were addressed in the planning application”.

He is also calling for the HSE to disclose where they have been referring people with residential needs since Owenacurra stopped taking new clients in 2021.

Mr Quaide added: “I would much prefer to be working in a constructive, cordial manner with HSE management on these issues over the next five years than having to take an adversarial approach in Oireachtas committees and across the airwaves and feeling like progress comes from sustained, attritional battle instead of reasonable, collaborative engagement.”

The HSE said that Cork Kerry Community Healthcare is developing a new 10-bed rehabilitative residential unit in Midleton town, on the site of the current Owenacurra facility: “Contractors are currently being engaged and construction is due to commence at the end of April 2025.”

On the topic of specialist residential services, the HSE spokesperson said: “The statutory responsibility for social housing lies with the relevant local authority, however our mental health services work in close co-operation with housing bodies to ensure that people with complex needs can access independent accommodation.”

They continued: “The capital funding to develop a site in St Stephen’s encompasses the development of a Community Rehabilitation Residence (CRR) to replace the existing continuing care service there.

“This will be designed in an appropriate and non-institutional manner.

“With regard to concerns raised regarding the appropriateness of St Stephen’s Campus, we have been assured by HSE Estates that the units will be designed in such a manner that they will not be institutional and will be separate from any other building on the land adjacent.”