Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

It has been the experience of north Dublin mental health service clinicians that most of the cases presenting to the emergency department at Beaumont Hospital out of hours and referred to the on-call psychiatry team are complex and multifaceted and often require the input of other hospital services. Persons presenting, for example, with intoxication, overdose, confusion or self-harm require assistance with these issues and, while there may be an allied psychiatric condition, other aspects of their care will fall to the emergency department to deal with first. Acute mental-health units, such as the Ashlin unit, are not designed or staffed to deal with these issues. Direct admission to a psychiatric bed without a thorough medical assessment would constitute a significant risk for patients. As there are no plans to include an out-of-hours assessment centre at the unit, persons presenting with complex issues are first assessed in the emergency department.

North Dublin mental health services work in partnership with Beaumont Hospital liaison psychiatry and the emergency department so that the needs of individuals requiring mental health services are co-ordinated to ensure optimised patient care. Two nurses assigned to the self-harm programme of the mental health service work in the emergency department. An additional self-harm nurse at clinical nurse specialist level is also being recruited. It is acknowledged that north Dublin mental health services have recently experienced some difficulties in terms of bed capacity. However, the HSE is working proactively to address these issues, with the number of available acute beds being kept under review and the recent approval of funding to facilitate onward discharges to community placement. The Ashlin Centre currently has 38 psychiatric adult beds, of which 37 are occupied. Approval is being sought for a further ten beds for 2016 as part of the ongoing development of north Dublin mental health services.

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