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Press Statement: Survey of Consultant Psychiatrists shows increase of mental health referrals and relapse amongst those with mental illness following Covid-19 pandemic
Survey of Consultant Psychiatrists shows increase of mental health referrals and relapse amongst those with mental illness following Covid-19 pandemic and subsequent restrictions.
Click here to view a longer summary of the results of the survey.
As coronavirus restrictions begin to ease, a survey of Consultant Psychiatrists carried out by the College of Psychiatrists of Ireland shows the emergence of a new mental health curve that will need flattening. With a worrying increase in referrals, urgent and acute presentations to specialist mental health services and relapses, a previously predicted surge in mental illness presentations looks increasingly likely.
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
Commenting Dr William Flannery, President said,
“Although a longer period to gather more data is needed as predicted an increase in presentations and incoming pressure on the mental health services is clearly arising, and concerns about the impact of this an already overburdened, underdeveloped Mental Health Service in Ireland are chief amongst Consultant Psychiatrists and their teams”.
This mental health curve arising needs to be urgently addressed and flattened by the incoming government with a national multi-sectorial taskforce, clear leadership and doubling of the funding to Mental Health Services required.
*When discussing suicidal ideation and self harm, the majority of consultants identified that the number cases they were seeing in the past month had increased or significantly increased (46%, N=62) compared to before the lockdown with a smaller (14%) reporting grater lethality in methods being used in self-harm. The importance of monitoring these rates was a concern amongst a majority, and that it was difficult to determine, at this stage, if rates are increasing overall or not.
See also: full report with further data