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HSE axing of service for self-harm patients is disgraceful – Ó Caoláin

19 May, 2008

Sinn Féin Health spokesperson and Cavan-Monaghan TD Caoimhghín Ó Caoláin has revealed that the Health Service Executive has axed a service to patients who self-harm and who have presented at Accident and Emergency Departments in Cavan and Monaghan. The role of Specialist Liaison Nurse was established in 2006 and the service has been catering for growing numbers of people who have self-harmed. However, the service has now been discontinued.

Deputy Ó Caoláin said:

"I have learned that the Health Service Executive management in Cavan and Monaghan decided in April to discontinue a very essential and valuable service that has been assisting many people in Counties Cavan and Monaghan since 2006. These are patients who present at A&E having deliberately harmed themselves. It is a very serious mental health issue with such patients being clearly identified as at risk of suicide.

"At a meeting held at the start of April this year HSE management decided to discontinue the service being provided by a Specialist Liaison Nurse. HSE management has since claimed that this was done in order to 'conduct a review' of current service and future needs.

"It is disgraceful that such a vital service has been discontinued. It is totally disingenuous for the HSE to claim that the service is being 'paused' for the purposes of a review. If the service was working well - and it clearly was - then it should have been left in place and only altered if a review found that change was necessary for the better care of patients.

"It is obvious that the motivation for axing this service is not the needs of patients or any real review of the effectiveness of services provided. Instead it is yet another HSE cost-cutting exercise designed to trim budgets regardless of the impact on patients.

"I have learned from the National Office for Suicide Prevention that they are part funders of the Specialist Liaison Nurse role and have in fact provided the HSE NE with part funding for the appointment of two Specialist Liaison Nurses to cover Cavan and Monaghan. However, a second appointment has never been made by the HSE. The National Office for Suicide Prevention has, I am advised, now written to the HSE North East requesting the return of the 50% funding they have provided for these posts.

"This latest cut worsens the already inadequate and under-resourced mental health services in these two counties, especially for younger people. Since February last the HSE North East has only been accepting urgent or emergency child and adolescent psychiatric referrals from GPs in Cavan and Monaghan.

"The HSE Department of Child and Adolescent Psychiatry (Cavan and Monaghan) wrote on the 12th February to all General Practitioners across Cavan and Monaghan advising that 'with regret…we will only be able to accept urgent or emergency referrals' as and from 18th February.

"The service's Consultant Psychiatrist Dr. Maeve Doyle has pointed out that staffing levels are inadequate to meet the needs of the Child Psychiatry Service which prioritises the assessment and treatment of children and adolescents with serious mental health problems. There are 6.5 whole-time equivalent posts for Cos. Cavan and Monaghan, a catchment area of 120,000. There should be 11 clinical staff per county, i.e. 22 for Cavan/Monaghan plus three secretarial staff. The service has been working with this inadequate staffing level since 2004.

"In Febraury last in the Dáil I pressed Tánaiste and Finance Minister Cowen, now an Taoiseach, on the underfunding of mental health services and asked him to provide the necessary resources to ensure the delivery of the commitments made in the Government's mental health strategy document, A Vision for Change.

"The then Tánaiste praised the psychiatric services available in Cavan-Monaghan, saying that the counties had spearheaded care in the community. However, Minister Cowen failed to respond to my question on child and adolescent psychiatric services in Cavan and Monaghan and the funding of mental health services generally across the country. Now we have an example of a HSE cut directly affecting that care in the community model, the withdrawal of essential after-care visits and the support of the sole Specialist Liaison Nurse serving both Counties Cavan and Monaghan.

"I will continue to demand of this Government that they call an immediate halt to HSE cuts, and in particular that they restore these essential services for all who need them in Cos. Cavan and Monaghan." ENDS

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