Additional funding as part of Budget 2027 is to be announced for more staff Alamy Stock Photo
Must ReadMental Health
More than half of the regional maternity hospitals providing mental health services are not operating at full capacity.
TWO MATERNITY HOSPITALS are not currently providing specialist mental health services for pregnant women and new mothers due to staffing constraints.
Five other hospitals currently only operate four days a week, meaning that more than half of the regional sites outside large cities providing maternal mental health services are not operating at full capacity.
Portiuncula University Hospital in Galway and Regional Hospital Portlaoise in Laois do not currently have any perinatal mental health midwives employed as part of Specialist Perinatal Mental Health Services (SPMHS).
These services provide support for women who are experiencing moderate to severe depression during pregnancy and after giving birth.
SPMHS are supposed to operate in 19 maternity hospitals across the country, split between six main hubs and 13 smaller spoke sites.
The six hubs are staffed by multidisciplinary teams and operate out of the National Maternity Hospital, Coombe Hospital and the Rotunda Hospital in Dublin, as well as the maternity hospitals in Cork, Limerick and Galway.
The other 13 maternity hospitals across the country are staffed by perinatal mental health midwives as part of the ‘hub and spoke’ model of care.
In the case of Portiuncula, recruitment is underway for a mental health midwife, while in Portlaoise, there is a provision for a consultant psychiatrist to provide help on a 0.3 working time equivalent basis.
This means that they spend 30% of their working week helping pregnant women and new mothers, though they aren’t available all the time or part of a formal service.
The information was provided to Labour TD Marie Sherlock, who told The Journal it was “desperately serious” and said, to her, it “speaks volumes about the lack of importance afforded to mental health within maternity services”.
Sherlock said that there is a decade-old commitment as part of the National Maternity Strategy to provide perinatal mental health support across all hospitals, but two hospitals don’t have any services, while five others aren’t operating on a full-time basis. She added:
We hear sweeping statements that perinatal mental health care is available across the country. It is not and it’s not [available] in a timely fashion in the majority of units.
“It’s quite remarkable,” Sherlock said.
A spokesperson for the Minister of State Mary Butler said that funding has been provided for a mental health midwife and that “it’s up to the hospitals to keep those posts filled”.
As part of Budget 2027, an allocation has been provided for an additional perinatal mental health midwife for each of the 13 maternity hospitals operating as spoke sites.
This would bring their allocation up to a minimum of two.
Some hospitals operating four days a week
In addition to two hospitals not providing SPMHS, five others currently only operate four days a week.
This means that more than half of the 13 smaller SPMHS sites are not operating at full capacity.
University Hospital Kerry, Tipperary University Hospital, University Hospital Waterford, Letterkenny University Hospital and Sligo University Hospital are the five hospitals that only operate SPMHS from Monday to Thursday.
Only Waterford has the ability to operate additional services “on some Fridays in response to service demand”.
The Journal Investigates recently found that increased demand for SPMHS at the hub sites is leading to wait times for appointments lasting over a month for many women in crisis.
Some hospitals have also tightened their acceptance criteria for these services in recent years as demand increases, meaning some women are being missed or are instead referred to their GP or counselling services.
Records obtained by our investigative team show how one SPMHS had to tighten its criteria because “providing the current level of care is no longer sustainable”.
Many women said that having to travel to an alternative site to seek care was a major barrier, particularly when caring for a newborn baby at the same time.
Sherlock told The Journal that “it’s a reflection that the service itself is not being taken seriously”.
She added that physical health is still being prioritised, “but we need to start saying that mental health is just as important.”
A spokesperson for the Department of Health said that “only a very small number” of posts within SPMHS are currently vacant.
They added that while funding is provided by the Department, “responsibility for recruitment, vacancy management and rostering rests with the HSE.”
“Minister Butler expects all funded posts to be maintained and quickly filled whenever vacancies arise,” the spokesperson added.
A review of the model of care – currently underway by the HSE – will also focus on “strengthening the multidisciplinary capacity of the 13 spoke sites so they can operate as more self-sufficient services, reducing reliance on hub teams while improving local access to care”.
The HSE did not respond to a request for comment in time for publication.
This article is part of a project supported by the News Reporting Scheme.
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Conor O’Carroll is an investigative reporter with The Journal Investigates.