Dr. Susan Finnerty:

Regional variation is a feature of the Irish mental health services. There is no uniform staffing and no uniform provision of service throughout the country. Covid has probably highlighted this in some sense in that, given the provision of therapeutic services by a small number of allied health professionals, when they were unable to deal with people during the Covid crisis, this set it up in sharp relief that there are not enough services or enough resources in community services.

The difficulty is that if there are not enough resources in the community services, then people will naturally gravitate towards the admission units, which leads to a difficulty on discharge because there is very little follow-up. Therefore, the problem of lack of access to community services is not just part of Covid, but Covid has made it worse.

Some areas are particularly poorly staffed with allied health professionals and consultant psychiatrists. This can be for a number of reasons, including difficulties with the retention and recruitment of staff and with staff not working wanting to work in isolated areas. It is multifactorial. Where there has been a history or tradition of intensive provision of service, the funding will stay. It is more difficult for areas where there has not been a very high level of provision of inpatient services. I refer to when the old asylums were open. It is difficult for the affected areas to get the funding to match that of other areas. There is a wide variation in funding and staffing resources across the country.