Press release
Minister for Mental Health and Older People welcomes publication of Health Research Board NPIRS Report
From Department of Health
Published on
Last updated on
From Department of Health
Published on
Last updated on
Mary Butler TD, Minister of State for Mental Health and Older People today welcomed the publication of the Health Research Board’s (HRB) National Psychiatric Inpatient Reporting System (NPIRS) Activities Report 2019.
The HRB Activities Report highlights some positive trends including a reduction in admissions to Irish psychiatric units and hospitals, from 17,000 in 2018 to 16,710 in 2019 and a considerable decline in the length of stay over the past decade, from an average of 82.7 days in 2010 to 64.2 days in 2019. Additionally, the Activities Report shows the increase of children and adolescents admitted to dedicated child and adolescent psychiatric units, and a corresponding decrease in the number of children and adolescents admitted to adult psychiatric units and hospitals. Of the 497 children admitted to psychiatric units and hospitals in 2019, 54 were admitted to adult psychiatric units and hospitals, a decrease from 84 in 2018.
The Minister of State with responsibility for Mental Health and Older People, Mary Butler TD said:
"Whereas I welcome this decrease in admissions of children and adolescents to adult psychiatric settings, more work needs to be done to ensure that this number continues to decrease. We need to build on the significant progress that has already been made, in order to further reduce the number of children admitted to adult psychiatric settings and ensure that our children get the care that they need in appropriate settings. Additionally, the decline in the average length of stay in recent years is welcome evidence of significant progress in the move away from institutional care to care based in the community."
The Activities Report also shows an increase in the number of under 18-year-olds admitted to psychiatric units and hospitals in Ireland, rising from 408 admissions in 2018 to 497 in 2019. The HRB acknowledges that this increase could reflect an increase in the number of places, a real increase in admissions or a combination of both.
Admissions from the female child population remain consistently high in relation to their male counterparts, with 65% admissions of the under 18-year-old population being female.
While depression remained the most common diagnosis among children, admissions for an eating disorder increased from 33 in 2018 to 54 in 2019. This increase is particularly notable in females; girls and young women accounted for 96% of admissions with an eating disorder. This is an increase from 80% in 2018.
Minister Butler said:
"Data is extremely important to map the very many challenges we face in Mental Health. This report is very useful as it not only highlights areas in which progress is being made, but also shows us where improvement is required. One area of grave concern that will need to be prioritised is the significant rise of psychiatric admissions connected to eating disorders by over 15%. Furthermore, the consistently disproportionate numbers of girls and young women being admitted to psychiatric units and hospitals is a worrying trend that will need to be focussed on and addressed."
The HRB plays an important role in supporting high quality monitoring, evaluation and research to ensure policies and practices are evidence informed.
ENDS
HSE Service Plan 2020 prioritises continued development of all aspects of CAMHS, including improved access, reduced waiting lists and better integration with Primary Care or other relevant care programmes or agencies such as Disability.
Despite increasing demands overall on CAMHS, individual cases professionally assessed as requiring urgent access to services receive priority.
CAMHS has seen a 25% increase in referrals between 2012 and 2019. The CAMHS Waiting List increased by 4% over that period – from around 2,400 to 2,500. Case complexity has increased over recent years, as improved admission pathways have been introduced. In 2008, there were 16 CAMHS Acute Inpatient beds. At end 2019, there were 74 CAMHS Acute Inpatient beds. In 2008 there were 49 CAMHS teams; and 71 in 2019.
There has been significant progress on age-appropriate admissions since 2008 when there were 263 such admissions to adult units (including admissions to private hospitals). This declined to 84 admissions in 2018, and 54 in 2019 to adult approved centres (including private hospitals). This represents a reduction in the proportion of children admitted to adult units from around 75% to 25.
(It is important to note that the number of admissions does not necessarily equate to the actual number of children admitted, as an individual child may be admitted on more than one occasion in any given year.)
Recently a number of tailored initiatives has been introduced for younger people, including:
A new 10-bed forensic CAMHS unit will open in 2021 at the National Forensic Mental Health Service (NFMHS) at Portrane, following opening of the main hospital in late 2020. A further 20 CAMHS beds are planned for the National Children’s Hospital (including 8 beds for eating disorders). This will increase overall national bed provision from 74 at present to 104.
The national mental health policy, Sharing the Vision – A Mental Health Policy for Everyone was launched in June. This policy, which builds on A Vision for Change, was developed following a process of research into international innovation and best practice in mental health and an extensive national consultation of over 1,000 service users, family members, friends and carers and other stakeholders.
Sharing the Vision envisages a mental health system that addresses the needs of population though a focus on the requirements of the individual.
The key outcomes identified are:
The policy takes a lifecycle approach and seeks to promote positive mental health and build resilience at all ages and stages in people’s lives, specifically outlining recommendations to promote positive mental health and wellbeing among children and young people.
Additionally, the policy seeks to improve timely access to evidence-based supports and services for service users, and advocates for a system that works in partnership with service users. Consequently, the policy has recommendations around enhancing CAMHS services, specifically with regards providing appropriate supports for those transitioning CAMHS to general adult services, and re-examining the age of transition, as well developing individualised support packages for the specific needs of children and young people who have complex needs.
Moreover, in relation to trends among girls and young women, Sharing the Vision recommends that a joint project be undertaken by the National Implementation and Monitoring Committee and the Department of Health’s Women’s Taskforce to outline an effective approach to the mental health of women and young girls.
Finally, Sharing the Vision fully supports evidence based research, such as that carried out by the HRB in order to ensure accountability and continuous improvement over the lifetime of the policy, as well as to monitor implementation, and moreover recommends that a National Population Mental Health Services Research and Evaluation Strategy should be developed and resourced to support a portfolio of research and evaluation activity.