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Home > COVID-19 Impact on secondary mental healthcare services in Ireland. College of Psychiatrists survey issued to consultants June 2020.

College of Psychiatry of Ireland. (2020) COVID-19 Impact on secondary mental healthcare services in Ireland. College of Psychiatrists survey issued to consultants June 2020. Dublin: College of Psychiatrists of Ireland.

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Almost 200 College member consultant psychiatrists (N=195) responded to its ‘Covid-19 Impact on Mental Health Services’ survey from across Ireland, the majority of which were (84%) from community healthcare services (HSE CHO Community Health Organisations). (The College survey was sent to 623 consultant psychiatrists and achieved a 31% response rate). As expected, 68% of respondents saw an initial lull in referrals to mental health service following the “lockdown” on 27th March with a subsequent increase in the second month of lockdown (April 24th to May 22nd).

 

Strikingly, when compared with numbers prior to the lockdown, 1 in 3 consultant psychiatrists (35%, N=48) saw an increase in the number of emergency referrals and 50% cited the number of patients experiencing a relapse of mental illness as having increased (N=66).

 

Other key findings:

  • 59% of respondents also felt that demand for inpatient beds had increased in the past month compared to the first month of the lockdown.
  • The number of new referrals to secondary mental health services in the past month had increased or significantly increased according to 72% of consultant psychiatrists compared to the first month of lockdown with 35% believing the number of referrals had increased compared to from before the lockdown.
  • Approximately 80% of consultants felt that social isolation and reduced access to face to face secondary mental health supports was contributing to emergency presentations.
  • Additional factors such as reduced access to local counselling supports and general practitioners, abuse/neglect in the home environment and increased reliance on drugs/alcohol were also believed to be contributing to emergency presentations. The impact of school closure was also highlighted as a significant stressor.
  • A swell in presentations across the range of mental disorders in the past month compared to the first month of the lockdown are reported such as: 64% saw increase in self-harm/suicidal ideation*; 57% in new onset depression; 79% in generalised anxiety with many reporting increased complexity in presentations across this range.

 

Although referrals were down in the initial phase of the virus, psychiatrists have seen an increased workload for the duration of the pandemic thus far, with teams continually adapting services to incorporate new technologies and delivery of assessment via telephone/video-link, adjusted referral pathways and colleagues being on leave. Many consultants commented that while consultant staff and Multi-Disciplinary Team members had adapted rapidly to changes and new referral pathways these adaptations have left clear staffing deficits exposed.

 

Along with precautions around the spread of Covid-19 in healthcare settings has come the widescale rollout of patient assessment using telepsychiatry methods. However, 67% of 87 respondents who answered the IT questions felt they were ill equipped to conduct some/most or all duties from an IT perspective. Respondents noted no availability or poor signal of Wifi in offices, and that personal home Wifi connections were also causing issues with the use of telepsychiatry assessment

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