THE HSE HAS said that it “greatly regrets” that it is not in a position to reopen an 11-bed ward at the Linn Dara Child and Adolescent Mental Health Services (CAMHS) inpatient unit, a year and five months on from its closure due to a lack of staff.

Only 13 of the 24 beds at Linn Dara have been operational since the Hazel Ward was closed in May of last year.

The HSE had been aiming to reopen the 11-bed ward in September, but as it is facing “challenges in recruiting the necessary staff”, it is not in a position to give a reopening date.

Bodywhys, the eating disorder support service, has said that “given the rising prevalence of eating disorder cases”, there is an “absolute need” for full bed capacity to be reinstated at Linn Dara. 

“The recruitment process needs to be progressed as a matter of urgency,” Ellen Jennings, the organisations communications officer said. 

Before its closure, the Hazel ward typically cared for the younger cohort of children aged under 16 at Linn Dara.

It provided specialist eating disorder care for four children at a time, and care for children admitted for other mental health conditions.

A spokesperson said that the health service is now pursuing every possible avenue to recruit psychiatric nursing staff. 

Linn Dara, which is based on the Cherry Orchard hospital campus in Ballyfermot, is a vital unit when it comes to Ireland’s ability to provide inpatient care for children with severe eating disorders.

It is the only CAMHS inpatient unit where staff are trained to provide nasogastric tube feeding to patients who need it.

Nasogastric tube feeding is an option for patients who are struggling to eat orally, as a means of providing short-term nutrition and feeding, and to administer fluids and some prescribed medications.

It can be used on a voluntary basis, but in a small number of cases it is used under a court order made by a judge, in a situation where someone’s life is at risk. 

The lack of nasogastric tube feeding provision across the HSE’s other inpatient CAMHS units can act as a barrier to children being treated for eating disorders on general hospital wards being able to access specialised inpatient care, in cases where they are partly reliant on the method.

In addition to Linn Dara, there are three other inpatient CAMHS units in Ireland, including St Joseph’s Approved Centre in Dublin, Eist Linn in Cork, and Merlin Park in Galway.

The only specialist eating disorder beds on offer are in the Linn Dara and Merlin Park centres.

Jennings from Bodywhys said that Linn Dara’s services are crucial in delivering interventions, supportive care, and close supervision for children with complex mental health conditions “that may not be feasible through community or outpatient settings”. 

The HSE is promising a new 8-bed eating disorder unit in the new National Children’s Hospital, but there is no clear date set for when that will be up and running, as the building project has become massively delayed and has gone well beyond budget.

A spokesperson for the HSE stated that despite the ongoing closure of the Hazel Ward at Linn Dara, referrals for admissions to CAMHS inpatient units continue to be processed in line with operational guidelines.

These specialist eating disorder beds will be on a CAMHS unit that will also include 12 general beds, which is to be headed up by the Linn Dara team.

Multiple healthcare workers within CAMHS services have told The Journal that they are unsure that the HSE will be able to recruit psychiatric nursing staff to man this new 8-bed ward when it eventually does open, considering that all of the beds within the system at present are not operational.

“The Linn Dara unit participates in a weekly national tele call of all 4 CAMHS inpatient units, other units will offer admission in cases where a bed is unavailable in the unit for that catchment area,” a spokesperson said.

Speaking on the ongoing closure of the Hazel ward,  the spokesperson said: “We and our staff greatly regret the effect this situation may have on patients and staff. We will continue to give the highest priority to all cases that require admission.” 

The HSE said it is aware that it needs to make “substantial changes and improvements” in the mental health services provided to children in Ireland.

It says the steps it is taking to do this include progressing a new HSE Child and Youth Mental Health Service improvement programme, and the establishment of a new national office for child and youth mental health, which is going to provide “enhanced governance to services”.

It intends to appoint both a national lead and a national clinical lead to this office.