AT THE CURRENT rate of funding, it could take over six decades to set up the required number of early intervention in psychosis (EIP) teams in Ireland, Sinn Féin’s spokesperson on mental health has warned.
There are five EIP teams in Ireland at present, but they are not all fully staffed and currently only treat adult patients, as previously reported by The Journal.
Each year in Ireland an estimated 1,500 people develop a psychotic disorder for the first time.
The earlier a person’s symptoms are treated, the better the outcome. Delayed treatment for psychosis can impact people’s quality of life for decades.
No new funding was granted for the National Clinical Programme for EIP services in 2023 or to date in 2024, despite experts in the sector calling for more investment.
From 2015 to 2022 €3.68 million was invested in EIP services, but no new funding has been granted since then.
The average annual investment in EIP services from 2015 to 2022 was €408,000.
Sinn Féin TD Mark Ward said, at this rate of investment, it would take more than 60 years to fund the 20 additional teams the HSE estimates it needs to meet the current level of demand for services.
The main symptoms associated with a psychotic episode are hallucinations and disturbed thoughts. Some people have a one-off psychotic episode, but don’t develop a related disorder. However, others develop schizophrenia, delusional disorder or schizoaffective disorder.
An EIP team is a multi-disciplinary team led by a Consultant Psychiatrist. Team members include a range of disciplines with clinical expertise in family work, CBT, physical health care, employment, functional recovery, medication and dietetics.
In response to a parliamentary question by Ward, the HSE confirmed there was “no new funding for EIP team development in 2023″ and “currently no agreement on funding for EIP services in 2024″.
The HSE estimates that an additional 20 EIP teams are required “to ensure everyone presenting for the first time with psychosis in Ireland gets access” to EIP services.
The HSE said, “at current rates of pay”, it would cost around €2.5 million to set up a fully-staffed EIP team in an urban area, with a high incidence of psychosis providing care to a population of 200,000 people aged 14 to 64 years.
Ward told The Journal: “This is the second year in a row where there has been no new funding for new development in early intervention for psychosis.
At the rate we’re going, it’s going to take more than 60 years to fully fund the number of teams needed.
In the coming years the level of need for services could also increase, meaning further teams would be required.
An additional €10 million in funding for mental health services was announced in January but many different services are vying for investment and it’s not clear if EIP will get any of this money. Negotiations are ongoing behind the scenes.
Nobody under the age of 18 currently has access to an EIP team in Ireland. Many people who experience psychosis have their first episode when they are a teenager or are in their 20s.
The country’s first CAMHS EIP team is expected to start seeing patients in the near future. This will serve the Dublin and North Wicklow area and “will allow young people to transition in a seamless manner if required”, a HSE spokesperson said.
This service is being funded by money from the Department of Health Women’s Health Taskforce; about 65% of young people who experience psychosis are girls.
As well as the positive impact EIP teams have on patient outcomes, they are also cost-effective.
Research has shown that for every €1 invested in EIP services there is a return of €18 saving to the economy due to a reduction in hospital admissions, relapses and crisis presentations, as well as increased retention in employment and education.
“Failure to invest by this Government makes no sense on a human or economic level,” Ward said.
A spokesperson said that while it the HSE’s “long-term vision is to support the development of specialist EIP teams across the country”, General Adult Mental Health Team (GAMHT) services are currently in place to “meet the needs” of people living with a diagnosis of psychosis.
“Anyone who is concerned about themselves or their loved one being at risk of a first episode psychosis should contact their GP for referral to their local GAMHT. Anyone who has a diagnosis of psychosis and is not in the catchment of a pilot EIP team should to continue to engage with their local GAMHT.”
The five EIP teams currently in operation for adult patients are “at various stages of development and resourcing”, the spokesperson added.
These teams are based in the following regions: Cork-Kerry Community Healthcare; Community Healthcare Organisation Area 1 (covering Sligo, Leitrim and South Donegal); Community Healthcare East (covering parts of Dublin and Wicklow); and the Midlands Louth Meath Community Health Organisation.
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Read more articles in this series >>
FALLING THROUGH THE CRACKS
How are inadequate services impacting young people with psychosis?
By Órla Ryan
The Journal and Noteworthy are exploring access to services for people with psychosis and/or schizophrenia as part of a wider series called Falling Through the Cracks.
We would like to hear from teenagers and young adults – or their parents / guardians – who have been impacted by the lack of services available to them. Please email orla@thejournal.ie to share your story.
Supported by the Rosalynn Carter Fellowship for Mental Health Journalism in the Republic of Ireland in partnership with Headline, a Shine programme.
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If you have been affected by any of the issues mentioned in this article, you can reach out for support through the following helplines. These organisations also put people in touch with long-term supports:
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