A ban on recruitment introduced by the Health Service Executive (HSE) earlier this month could have serious implications for the implementation of the current national mental health policy, a consultant psychiatrist has said.
Speaking after delivering a keynote address to the Health4Life conference at Dublin City University (DCU) last week, Dr Siobhán Barry said key appointments envisaged under the Vision for Change plan may now be put on hold.
However, she noted that as part of its commitment to provide well-trained, fully staffed community mental health teams, Vision for Change proposed a minimum staffing level of 20 staff per 50,000 population.
This included consultant psychiatrists, psychologists, psychiatric social workers and nurses, occupational therapists and mental health support workers.
Dr Barry is the clinical director of the Cluain Mhuire mental health service in Blackrock, Co Dublin and public relations officer of the Irish Psychiatric Association.
While her own team, which covers a population of 60,000, had witnessed a "huge improvement" in staffing levels when compared with one year ago, it still had the equivalent of just nine and a half full-time staff, Dr Barry said.
It also does not have any occupational therapists or mental health support workers, she said.
She noted that a progress review of Vision for Change completed last July had found that much remained to be done when it came to implementing the plan since its launch in January 2006.
Following the publication of this review, the HSE said it planned to hire an individual whose role would be to drive the implementation of Vision for Change, but this had not yet happened, Dr Barry said.
Referring to a HSE memo circulated this month and which announced a temporary suspension in the appointment of staff, Dr Barry said it included all categories of staff and contractual types as well as offers of employment which, it said, should be temporarily deferred.
"They need to make up their mind, do they want to implement it or do they want to stay within budget.
"Quality mental healthcare and good outcomes tend to require higher staff to individual ratios," she told The Irish Times.
A range of innovative but relatively staff-intensive programmes introduced at Cluan Mhuire had been shown to be successful, despite being significantly underfunded, she added.
In a separate presentation, researchers at DCU's school of nursing said that the social and cultural aspects relating to the spread of hospital-acquired infections such as MRSA merit more thorough investigation here.
In particular, the "visibility and invisibility" of the role of hospital cleaners and the social hierarchy of hospitals, as well as staff shortages and patient overcrowding warrant attention, members of DCU's organisational process research group said.