Dr. Susan Finnerty:

Regarding the overcrowding in some units, it is interesting to note with regard to where someone lives in the country whether his or her local psychiatric unit tends to operate at over or under capacity. There are examples of both. The Chairman mentioned Tipperary and the south east. Two psychiatric units in that area have closed - St Senan’s psychiatric hospital in Enniscorthy, which was an old asylum but had an admissions unit, and St. Michael's unit in Clonmel, which was an acute psychiatric unit. What has fallen behind is the development of community services in that area. While the number of beds has been reduced, community services such as home-based treatment teams have not been put in place. The area has crisis houses but they tend to get blocked up. Admissions tend to be much lower in Cavan-Monaghan, which has well-developed community services, and services do not operate at over capacity. The key is the development of community services, not necessarily more beds. It involves stopping people getting into acute units and not being able to be discharged. Rehabilitation, which I mentioned earlier, is an example of that. Without developing rehabilitation services, people will become long-stay patients in acute units and will block beds for people who need to come in.