23 May 2022

Shortage of mental health beds and support, Derry women say

Patients had to lie in the middle of a communal area due to overcrowding

Shortage of mental health beds and support, Derry women say

Two Derry women who suffer from complex mental health difficulties have spoken out about what they believe to be a shortage of beds and support for those experiencing a crisis.

It has emerged that in recent weeks a fifteen-bed female ward at Grangewood Hospital admitted seventeen patients - two of which had to lie in “communal areas for days”.

The friends, who wish to remain anonymous, have both been admitted to and discharged from Grangewood in the past month.  They have raised concerns that people are being allowed to leave the mental health facility while still feeling suicidal.

Both said that “bed shortages” in the city mean that Grangewood is overcrowded and patients are having to lie on mattresses in communal areas such as the “family room and TV room”.

“It’s an absolute joke,” one said, “No wonder people are dying in this town,” 

Grangewood Hospital (below) is an acute mental health inpatient unit situated in the central aspect of Gransha Park.  It provides the in-patient component of the Trust’s crisis intervention service.

It is divided into two wards, Evish and Carrick, with fifteen beds each.  Evish provides assessment and treatment for female patients aged 18-65 and Carrick provides the same service for male patients.

One of the women, who has been diagnosed with anxiety and depression, said it is “a revolving door” and the place is “constantly full” to capacity.

Her friend, diagnosed with borderline personality disorder echoed her view that patients are being discharged too early. 

Once back in the community they can attend day care services for a short period but then have to wait “at least six weeks” to access follow-up mental health appointments, they say.

“It is understaffed, there aren’t enough nurses, people in this city need more care and compassion.

“They essentially tell you to get on with it, but it’s hard, we need support.”

It leads them back to Altnagelvin’s A&E department, which they have attended on numerous occasions over the past year.  Last time, one of them had to wait nine hours to be seen.

“More beds are needed in the city, we haven’t got any medication at the minute so we’ll end up back in the A&E department and at square one again.

“We’re crying out for help and not getting it.”

Mental health register

The Western Trust’s corporate plan for 2019-2021 states that 3,254 people in the west are on the mental health register, WHSCT, in NI as a whole there are, 17,849 people.

Approximately 1 in 5 are on prescription medication for mood and anxiety.

In 2019 the Crisis Resolution & Home Treatment Team based in Grangewood received and responded to approximately 1,600 referrals from various departments within Altnagelvin Area Hospital including A&E Department.

The Trust plan outlines the need for “improved access to Child and Adolescent Mental Health Services (CAMHS) or Community Paediatric services” but also identifies as challenging an “Increase in demand” for this service.

Whilst it recognised there are challenges with the recruitment to the Mental Health Nursing workforce regionally, it says, at a local level within the Western Trust there is not currently a shortage of Mental Health Nurses.

A spokesperson said that “respecting confidentiality” the Western Trust does not comment on the individual treatment and care of its patients or clients.

She added: “Our current adult mental health acute in-patient bed compliment at Grangewood Hospital is 30 beds.

“The hospital is comprised of two wards with fifteen beds each, and an integrated function for intensive care and support for up to six people at a time.”

Grangewood opened in November 2012, replacing former “clinic buildings” at Gransha that had forty beds.

The reduction in bed numbers was part of a business case, in partnership with the Health and Social care Board, and the Department of Health, for Grangewood Hospital reflecting a model in-keeping with the vision set by the Bamford Review of Mental Health and Learning Disability.

‘Recovery oriented’

Western Trust adult mental health crisis services now operate a systems approach that seeks to support people as close to home as possible in times of crisis, the spokesperson said.

“Our crisis services are comprised of a Crisis Resolution & Home Treatment Team, acute day care, and in-patient beds. The Trust has a total bed compliment of 56 adult acute mental health in-patient beds between Grangewood and the Tyrone & Fermanagh Hospital in Omagh providing services to Western Trust residents and others in Northern Ireland within regional bed management protocols.

“Our Mental health services engage with people through recovery oriented interventions working collaboratively with the patient to promote hope, opportunity, and personal control and responsibility for their own wellbeing.”

She continued: “Our adult mental health crisis services promotes personal recovery through partnership and co-working supporting patients and clients to receive care in the community, only being admitted to hospital if it is necessary in the context of ‘stepped care’. 

“The stepped care approach is used to match a patient or client’s needs with the right level of support determined by their personal needs, and support which is known to help recovery.

“The stepped care approach means care can be stepped up or down.  A step up in care usually means someone needs more intensive support and treatment.  A step down in treatment usually means recovery is at a stage where the person no longer requires the same level of care and treatment. 

“Our Crisis resolution and home treatment teams provide a range of interventions including assessment as the basis for providing interventions and responses to meet individual needs. 

“Following assessment the crisis service is able to provide high intensity support and effective treatments for people with acute and highly complex mental health needs delivering intensive recovery focused support at home in the community, in hospital at Grangewood or through acute day care services.” 

If you need to speak to someone urgently, please call Lifeline on 0808 808 8000, the Samaritans or attend your local Emergency Department.

The Community Crisis Intervention Service provides a timely (within approximately 30mins), non-clinical, community response to individuals experiencing social, emotional or situational crisis over a timeframe of 8pm on Thursdays through to 8am on Sundays.

If you feel in crisis and need support or if you have observed someone who is in distress and may come to significant harm through self-harm and suicidal behaviour please call the Community Crisis Intervention Service on: 028 7126 2300

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