Staff praised as pressure mounts on mental health services at Kilkenny hospital
St Luke's Hospital in Kilkenny examined as part of Mental Health Commission’s ‘Acute Mental Healthcare in Emergency Departments in Ireland’ report
St Luke’s General Hospital in Kilkenny saw 330 mental health assessments carried out in its emergency department (ED) in 2023, according to a new national report.
The figures are contained in the Mental Health Commission’s ‘Acute Mental Healthcare in Emergency Departments in Ireland’ report, which examined mental health services in EDs across 35 hospitals.
St Luke’s is categorised as a Model 3 hospital, with a 24/7 emergency department.
Mental health assessments in the ED and on acute medical wards are provided by a consultation liaison psychiatry (CLP) team.
This team comprises one non-consultant hospital doctor (NCHD), three clinical nurse specialists (CNSs), and one administrative staff member.
Psychiatry supervision is provided on-call by the local HSE Community Mental Health Team (CMHT).
The report notes that the hospital’s ED uses the ‘Manchester triage system’ to prioritise patients presenting with mental health needs, including those experiencing self-harm, suicidal ideation, perinatal mental health difficulties, eating disorders, substance misuse, and young adults aged 18 to 25.
A dedicated consultation room is available at all times in the ED for nurse or NCHD mental health assessments. However, no structured risk assessment tool is used.
Referrals are made from the ED to local CMHTs, GPs, and other services such as homelessness or residential support services.
Patients are also signposted to self-help and addiction services.
The report highlights that, despite rising presentations, St Luke’s has no specialised staff for eating disorders and that consultation liaison psychiatry is not additionally funded beyond one self-harm CNS post.
A business case has been submitted to the HSE seeking a dedicated CLP psychiatry service for the hospital.
The CLP team was commended in the report for providing a strong service under pressure and for meeting the mental health needs of patients in the ED and throughout the hospital.
Despite this, the report warns that increased investment is required to meet rising demand.