Mental health crisis as NI psychiatric units struggle with occupancy levels amidst ‘ongoing bed pressures’

Craigavon Area Hospital, whose Bluestone Unit was found at the turn of the year to be using Portland chairs — chairs that can be reclined into a bed - “to increase bed capacity”.

Lisa Smyth Twitter

May 16 2022 07:45 AM

People experiencing a mental health crisis are being nursed in chairs due to a lack of hospital beds.

One of Northern Ireland’s psychiatric inpatient units is being forced to nurse patients in reclining chairs while staff are using paper to cover windows for their dignity.

It can be revealed the region’s health watchdog is carrying out a series of inspections of acute mental health inpatient services after concerns were raised about “ongoing bed pressures”.

The Regulation and Quality Improvement Authority (RQIA) said: “At present, demand for acute mental health inpatient beds in Northern Ireland has increased significantly and occupancy levels have escalated to over 100%.

“On occasions, there have been no commissioned beds reported as being available across Northern Ireland, leading to decisions to admit patients to contingency beds or, in some cases, to support patients to sleep on settees or chairs until such times as a bed becomes available”.

As a result, the RQIA has been carrying out a series of inspections to ensure patient care and treatment is safe.

During a visit to the Bluestone Unit at Craigavon Area Hospital between December 8 last year and January 10 this year, inspectors found the trust was using Portland chairs — chairs that can be reclined into a bed, “to increase bed capacity”.

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The inspection report said staff from each ward, with the exception of Rosebrook psychiatric intensive care unit (PICU), “described regularly being over occupied”.

The inspectors found that during periods of over occupancy, patients slept on reclining chairs in the quiet rooms; however, they noted this means other patients cannot use the quiet rooms, which the RQIA said “promote patient recovery and are recommended by the Royal College of Psychiatrists”.

In a further area of concern, nursing patients in the reclining chairs means they have to use communal bathrooms and therefore require one-to-one supervision due to the ligature risks in the facilities, which the RQIA said “is restrictive and impacts on privacy and dignity”.

It also emerged that some patients have been nursed in PICU when there weren’t enough beds available, despite the fact they did not need this level of support.

While the RQIA found the unit was providing safe care to patients, the inspection report continued: “In the non-designated areas there was nowhere for the patient to store their personal belongings, and there was also a lack of privacy and dignity as windows were not obscured.

“Nursing staff endeavour to maintain patient privacy and dignity by using paper to cover the window panes.

“It was evident that patient comfort is impacted during periods of over occupancy, however, staff were taking all necessary steps to maintain patient’s dignity, privacy and comfort when wards were operating over and above their commissioned beds.”

Sinn Fein MLA Orlaithi Flynn said the RQIA findings demonstrate the need for more mental health beds and called for the Executive to be set up to provide greater funding for mental health services.

Alliance Party MLA Paula Bradshaw called for increased community care beds to improve patient flow.

Jan McGall, director of mental health and disability services at the Southern Trust, said: “In the Southern Trust we are committed to providing safe, quality care with compassion and this inspection report recognises the dedication of our caring and compassionate staff to their patients.”