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Tsunami of young people seeking mental health care but too few beds, say consultants

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There is now a tsunami of distressed young people presenting in crisis to paediatric hospitals and to paediatric emergency departments in particular, hospital consultants have maintained.

However, the Irish Hospital Consultants Association (IHCA) said on Tuesday that at present it was not possible to provide appropriate urgent inpatient care to children and adolescents due to a severe lack of beds for this group of patients.

The IHCA also said the number of adult psychiatry beds available for acute admissions had been reduced to the point where there were “frequently no beds available at night in many of our community healthcare organisations (CHOs), and no co-ordinated national system to manage that availability”.

It said this represented “an ongoing patient safety issue” and that “ at least 300 additional adult psychiatric inpatient beds wererequired to meet recommended levels.

The association said only three-quarters of the available child and adolescent mental health service (CAMHS) beds were open at any one time.

It said in a pre-budget submission on mental health that in October 2020, there were 72 operational beds for the CAMHS service, out of a total of 98 CAMHS beds.

“There are CAMHS inpatient units in only three counties nationally, and these generally do not take out-of-hours admissions. Waits of up to six weeks for admission can occur.”

“This lack of a co-ordinated national system to resolve crisis situations when they arise presents a significant patient care and safety issue. Children and young people in crisis are left with the unacceptable ‘choice’ between an emergency department, general hospital, children’s hospital, or an adult inpatient unit,” the associatoin said.

The chairwoman of the IHCA’s psychiatry committee, Prof Anne Doherty, said overall mental health services in Ireland were experiencing a major shortfall in relation to beds and a major shortfall in relation to staff recruitment and retention.

Prof Doherty said as the population increased the mental health budget was not keeping pace. She said there were insufficient consultants, that the pandemic was placing increased strain on services and that a realistic mental health budget was needed.

The IHCA submission said that at 5.4 per cent of the overall health budget, funding for mental health in 2021 was proportionately the lowest level of spending since 2012. It said the mental health budget in Ireland was approximately half that of most northern European countries

She said there were also a lot of disparities within the various community CHOs across the country.

The IHCA submission said: “For example, CHO 7 (Kildare, West Wicklow, Dublin South), with a population 697,644, was allocated a mental health budget of €94.56million in 2019 and had a wholetime equivalent (WTE)complement of 835 in mental health in Dec 2018. With just 1 per cent less of a population (690,575), CHO 4 (Cork/Kerry) was allocated €116.68million (+23 per cent) for mental health services in 2019 and employed 1,483 WTEs – a 78 per cent difference in staffing. There is a 25 per cent difference in funding mental health services in CHO 7 compared with CHO 4 on a population basis.

The IHCA argued that the significant increase in paediatric mental health problems “warrants increased funding as part of the response to Covid-19”.

Dr Elizabeth Barrett, consultant child and adolescent liaison psychiatrist, said during the first Covid-19 lockdown there had been a drop in presentations and when restrictions eased there was a massive surge.

“Overall at times we have been seeing twice the number of patients that we normally see in a month. Across the Childrens’ Health Ireland (group) there has been about a 9 per cent increase overall.”

“We are seeing a lot of very distressed and anxious adolescents. We are seeing lots and lots of self-harm teenagers presenting. That is not surprising. We had been seeing that increasing over the last ten years but certainly there was an escalation during Covid. We have seen a huge increase in the number of eating disorders.”

The IHCA submission said one hospital had reported a 66 per cent increase in medically unwell young people with eating disorders needing admission.

It said there were currently just three eating disorder public beds for adults in the country – at St Vincent’s University Hospital – and that these were only available to those living in CHO 6 (Wicklow, Dun Laoghaire, Dublin South East.

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Covid testing rules for all arrivals into State come into force

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New Covid testing rules for travellers arriving into the State have come into force today.

At the start of the week the Government announced that all incoming travellers except those travelling from Northern Ireland will have to present a negative test result in order to enter the country irrespective of the vaccination status.

The move came in response to concerns about the spread of the Omicron variant of Covid-19.

The test requirements were due to be introduced from midnight on Thursday. However the system was postponed at the last minute to midnight on Sunday in order to allow airlines prepare for checks.

For those with proof of vaccination they can show a negative professionally administered antigen test carried out no more than 48 hours before arrrival or a PCR test taken within 72 hours before arrival. Those who are unvaccinated must show a negative PCR test result.

Ryanair’s Michael O’Leary had described the move as “nonsense” and “gobbledygook”.

Meanwhile more than 150 passengers have departed Morocco for Ireland on a repatriation flight organised by the Government.

The 156 passengers on the flight from Marrakech to Dublin included Irish citizens as well as citizens of several other EU countries and the UK.

The journey was organised after flights to and from Morocco were suspended earlier this week until at least December 13th, amid fears over the spread of the new Omicron Covid-19 variant.

The repatriation flight on Saturday was operated on behalf of the Government by Ryanair.

Responding to news of the flight’s departure, Minister for Foreign Affairs Simon Coveney hailed the efforts of the Irish Embassy in Rabat in the operation, tweeting: “Well done and thank you!”.

On Saturday the number of Covid patients in hospital has fallen to 487, the lowest level in almost four weeks, the latest official figures show. The number of Covid patients in hospital fell by 41 between Friday and Saturday. There were 5,622 further cases of Covid-19 reported on Saturday.

Tweeting about the latest hospital figures on Saturday, Tánaiste Leo Varadkar said the “plan is working – 3rd doses, masks, test & isolate, physical distancing. Thank you for what you are doing. Please don’t lose heart. Let’s all have a safe Christmas.”

The figures come as the Government on Friday announced its most wide-ranging introduction of new restrictions this year after “stark” warnings from the National Public Health Emergency Team (Nphet) to take immediate action in the face of the threat from the Omicron variant.

From Tuesday until at least January 9th, indoor hospitality will be limited to parties of up to six adults per table, while nightclubs will be closed and indoor events limited to half a venue’s capacity. Advice has been issued that households should not host more than three other households in their home, while the use of the vaccine pass is to be extended to gyms and hotel bars and restaurants.

Trinity College immunologist Prof Luke O’Neill said the main reason for the new restrictions was the new Omicron variant, and he thought they were needed as the “next three to four weeks are going to be tough”. Speaking to Brendan O’Connor on RTÉ radio, he said it was “strange” that restrictions were being introduced when things are stabilising, with the lowest hospital numbers since November 6th.

Prof O’Neill said he was “hopeful” at news that the Omicron variant may have a piece of the common cold virus in it which could make it more like the common cold.

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Divock Origi delivers late delight as Liverpool see off Wolves

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Wolves 0 Liverpool 1

Divock Origi’s last-gasp strike sent Liverpool top of the Premier League with a dramatic 1-0 win at Wolves.

The substitute fired in from close range in stoppage time just as it looked like the Reds would fail to score for the first time in eight months.

He spared Diogo Jota’s blushes after the forward hit Conor Coady on the line following Jose Sa’s second-half mistake.

Chelsea’s 3-2 defeat at West Ham gave the Reds a path to the summit and they went top thanks to Origi’s late show. Resilient Wolves were left with nothing despite another battling display and sit eighth.

Liverpool had blown away the majority of their rivals this season, having scored four in each of their last three Premier League games before arriving at Molineux.

They had, simply, been too good but found Wolves at their resolute best until the death.

Only Chelsea and Manchester City have conceded fewer goals than Bruno Lage’s side prior to the game and there was strong resistance to Liverpool’s threat.

The visitors failed to find any early rhythm, thanks largely to the hosts’ determination. Aside from Leander Dendoncker slicing a clearance from Jota’s header the Reds made few first-half inroads.

Three straight clean sheets had given Wolves’ defence renewed confidence and they continued to keep it tight as Liverpool slowly began to turn the screw.

Trent Alexander-Arnold volleyed over after 28 minutes and then turned provider for Jota, who headed his far post cross wide.

Liverpool had control but only managed to open their hosts up once and, even then, Romain Saiss’s presence ensured Mohamed Salah just failed to make contact with Andrew Robertson’s low centre.

As an attacking force Wolves were non-existent. Having scored just five league goals at Molineux that was no surprise but Adama Traore, Raul Jimenez and Hwang Hee-chan carried little threat.

Joel Matip and Virgil Van Dijk were on cruise control and apart from Rayan Ait-Nouri’s sharp run – before he wasted his cross – there was little for Liverpool to fear.

Yet, they were still searching for a goal. Having scored in every Premier League game since a 1-0 defeat to Fulham in March more was expected after the break.

Salah’s knockdown caused some penalty box pinball which saw Thiago Alcantara twice denied but Jürgen Klopp’s men lacked the fluidity and precision to break Wolves down.

They needed a mistake from Sa to create their best opening on the hour and even then Jota missed it.

The goalkeeper raced out to the left after Jordan Henderson’s searching pass for Jota but collided with Saiss to give the forward a clear run to goal.

He advanced but from just six yards belted the ball at the covering Coady on the line.

Alexander-Arnold drove over as Liverpool’s frustrations grew and Sa denied Sadio Mane late on.

But Origi had the final say deep into added time when he collected Salah’s pass, turned and fired in from four yards.

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Teenage girl travelling on scooter seriously injured in collision

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A teenage girl was seriously injured after she was struck by a van while she was travelling on a push scooter in Dublin, gardaí have said.

The collision happened on Walkinstown Avenue in Dublin 12 shortly after 6pm on Wednesday.

The teenager is being treated for serious injuries at Children’s Health Ireland Hospital in Crumlin. No other injuries were reported from the incident.

The scene was preserved for technical examination, and investigations are continuing.

Gardaí are appealing to anyone with information on the incident to contact them at Crumlin Garda station on 01-666-6200, the Garda confidential line on 1800-666-111 or any Garda station.

Any person, whether a motorist or pedestrian, who was travelling along Walkinstown Avenue on Wednesday between 5.45pm and 6.30pm is also asked to come forward.

Gardaí have asked that any camera footage is made available to them.

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