MORE THAN 80 Irish patients had to travel abroad for mental health treatment in a five -year period, according to new figures.
It is likely that the majority of these people travelled to the UK for treatment in a residential setting, experts have said.
Though the numbers each year are not high, there is concern about the impact on patients who have to travel to a different country away from their families and the clinicians they are used to dealing with.
Under the HSE’s Treatment Abroad Scheme, a consultant treating a patient in the public healthcare system can refer them to another EU-EEA member state for treatment that is not available here.
Patients can also apply if the treatment is not available with a certain period of time.
In response to a parliamentary question from Fianna Fáil TD James Browne, the HSE revealed that 81 Irish patients received mental health services abroad through this scheme between 2013 and 2017.
Browne said the numbers show there is “clearly a deficiency in services for those suffering with mental health illnesses”.
“We know that patients with mental illness recover better and more quickly when treated near family, friends and their community.”
Mental health services are also provided in Northern Ireland under the Cross Border Directive which allows patients from the Republic to access treatment that is available here.
The patient is required to pay for the treatment and then seek reimbursement from the HSE afterwards. In 2017 the HSE spent more than €27 million on treatment abroad schemes.
Speaking to TheJournal.ie, Mental Health Ireland CEO Martin Rogan said these patients are referred for a number of reasons, including long waiting lists for specialist treatment here and an absence of certain specialities in the mental health area in Ireland.
“It could be people who have used local options and have exhausted those local options. We also see it with people who have a dual diagnosis, either a learning disability with a mental health need or a very particular syndrome.”
A number of patients each year go to the UK for treatment in relation to an eating disorder as there is a specialist facility in England.
Rogan said that despite the fact that the health service is “poorly resourced”, there are few mental health issues that can not be treated here.
But with children’s mental health services in particular, he said clinicians are still going to encounter complex cases that warrant a referral overseas.
Shortage of beds for young people
There was criticism last year of the shortage of beds for children and young people with mental health needs.
Last year the Mental Health Commission revealed 82 children had been admitted to adult mental health units the previous year (up from 68 in 2016). The organisation said the level of service that was being provided was “unsafe and substandard” and that it breached the rights of a vulnerable group of people.
In November it was revealed that almost half of the beds designated for children and young people were not in use. The HSE said this was due to recruitment issues and safety concerns about employees and other patients. As of October last year there were 2,250 children and adolescents waiting to access mental health services.
More than 100 patients were waiting for over 18 months, but 78.9% of the overall number were offered an appointment within 12 weeks.
‘Work with the family’
Rogan said there are downsides to treating patients outside of their home country. The majority of these referrals are likely for treatment in a residential setting, which means patients may be away from home for weeks or months.
“Mental health is best treated with the person’s own family around, in their own home. We can learn from some indigenous health services across the world that are often described as primitive. They believe you must work with the family, you must work with the spiritual leaders and the community.
“You get much better outcomes if family is involved. The challenge in mental health is it should be the least intrusive, least disruptive model.”
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