Home > Implementing ‘A vision for change’: moving towards a modern, quality and responsive mental health service. Carlow / Kilkenny / South Tipperary.

Health Service Executive South. (2011) Implementing ‘A vision for change’: moving towards a modern, quality and responsive mental health service. Carlow / Kilkenny / South Tipperary. Kilkenny: Health Service Executive.

PDF (Implementing ‘A vision for change’) - Published Version

The key element of the HSE South’s Programme is to enhance and develop community mental health services in Carlow, Kilkenny and South Tipperary, to enable the service user to remain in the community to the greatest extent possible.

HSE South has prioritised the implementation of the change programme and has allocated more than €20m capital funding and over €1.75m revenue funding to support this comprehensive development programme.

Speaking at the briefings Mr. Pat Healy, Regional Director of Operations, HSE South said, “When this plan is delivered, clients will have access to the highest standards of services in all three counties, which should significantly improve these clients’ treatment programmes and quality of life. The National Service Users Executive are supporting the change programme, which is of immense importance to HSE South.

The programme heralds the enhancement and development of community mental health services, the closure of old long stay institutions, the separation of North and South Tipperary acute inpatient mental health services and development of appropriate acute inpatient services, for the extended catchment area, in line with the national strategy for mental health “A Vision for Change”. The programme also acts on recommendations of the Mental Health Commission.”

Mr. Damien Godkin, Senior Operations Officer, National Service Users Executive commented; “Implementation of the HSE South’s Programme for Carlow, Kilkenny and South Tipperary Mental Health Services will see the vast majority of patients and clients being treated in their homes and the community, through building on existing community mental health teams, home based treatment teams, outpatient clinics, hostels and day services. This is something that service users and their families welcome.”

“This approach to delivering services is fully in line with “A Vision for Change” and is considered best practice, both nationally and internationally. These initiatives will work to provide appropriate and safe alternatives to inpatient care and reduce the reliance on admission of patients to acute mental health facilities. I’m happy to support the HSE South’s programme, including plans to manage acute admissions on one site at the modern, purpose built unit in Kilkenny – which will be a big improvement on what we have had up to now.”

Executive Clinical Director for Mental Health Services in the Carlow, Kilkenny and South Tipperary area, Dr. Frank Kelly outlined some of the major changes:

“We will be enhancing community based mental health services to ensure that people using mental health services have easy access to appropriate care in the most appropriate setting. This will involve a system wide approach by mental health professionals, service users and their families, primary care teams, GPs and voluntary and community groups.”

Next Steps
The Change Programme will be implemented in line with the terms of the Public Service Agreement 2010 – 2014. Phase 1 (to the end of October 2011) will involve the transfer of North Tipperary acute inpatient services to HSE West and the redeployment of staff to develop community based services in South Tipperary. This is in line with the recommendations of the Mental Health Commission and will result in a reduction in approved centre status from 49 to 29 beds in St. Michael’s Unit. During Phase 1 there will be immediate engagement with Unions and Staff Associations to agree the smooth transition of services to HSE West.

Phase two will take place from October 2011 – March 2012 and will involve engagement with all stakeholders to deliver on the remaining elements of the change programme as outlined below:

Enhanced Community Mental Health Teams
* Development of the Core Community Mental Health Team to meet the increased demand for community services.
* Development of 2 new Acute Day Services (Day Hospitals) in Clonmel and Cashel and the enhancement of existing day services in Carlow & Kilkenny.
* Development of Home Based Treatment Teams to enable service users to receive treatment in their own home environment.
* Development of Crisis / Respite Accommodation which will offer alternatives to inpatient care.

Continuing Care Services
* Development of a new Community Nursing Unit in Clonmel.
* Development of a new High Support Hostel in Clonmel.

In Patient Services
As the community mental health services are enhanced, fewer people will require admission to hospital, in line with A Vision for Change. The 44 bed acute inpatientunit in St Luke's General Hospital Kilkenny will be the designated approved centre for the Carlow, Kilkenny, South Tipperary extended catchment area. The unit in St Luke’s complies with Mental Health Commission (MHC) requirements and has more than enough capacity for the population of Carlow, Kilkenny and South Tipperary. The acute bed allocation in the Department of Psychiatry, St Luke’s General Hospital Kilkenny, is being reorganised to accommodate admissions from South Tipperary.

St Michael’s Unit in Clonmel is an older unit about which the MHC has highlighted a range of service and infrastructural issues. The Unit is no longer fit for purpose and will cease to accept inpatient admissions as this change programme is delivered. All the appropriate community based services are to be in place by the end of quarter 1 2012 and this is the target date for St. Michael’s Unit to close. No services will cease until alternative community based services are in place. This target date will be kept under close review through the governance framework within the HSE and with the Mental Health Commission and the Department of Health to ensure quality and safe outcomes at all times.

Mr. Healy concluded by saying:
“It is estimated that one in four or five of us will experience some mental health problems in our lifetime. Most people with mental health needs can be treated by their GP and are referred to HSE Mental Health Services when necessary. Huge change has already taken place over the past number of years and I want to acknowledge the contribution and commitment of staff at all levels in bringing about this change. The programme we are outlining will see these changes continue. Significantly, and in line with best practice nationally and internationally, this plan is about moving from a hospital based model to providing more care in communities and in clients' own homes. I know that our dedicated teams of professionals at all levels of the service will continue to provide the highest of standards in the Carlow-Kilkenny/South Tipperary Mental Health Services and will work with us to ensure that this Programme succeeds.”

Notes for the Editor:
* “A Vision for Change” is the government’s national strategy for mental health. Published in 2006, following comprehensive consultations with stakeholders, including services users, advocates, carers, mental health professionals and voluntary organisations. It is recognised internationally as a progressive roadmap for achieving a world class mental health service in Ireland.
* The Mental Health Commission (MHC) is the independent statutory body, which promotes good practice and high standards in delivery of mental health services. The MHC carries out regular inspections and its recommendations are acted on by the HSE to promote continuous improvement in the service.

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