Portiuncula University Hospital’s (PUH ) Emergency Department came under scrutiny at this week’s Western Regional Health Forum on Tuesday, following a critical review by the Mental Health Commission.
The Commission’s April report highlighted a 12 per cent increase in mental health presentations in 2023, with a worrying 25 per cent rise in self-harm cases among children under 15. Substance misuse presentations also climbed, placing additional pressure on an already strained service.
Councillors expressed alarm, pointing to the hospital’s lack of an on-site mental health crisis unit despite serving a broad catchment in East Galway and South Roscommon.
“This is about mental health care, particularly for children,” said Cllr Evelyn Francis Parsons. “In 2023, there were 446 self-harm presentations – a 12 per cent increase. One in four involved children under 15. These are not abstract statistics; they reflect a system that is structurally under-resourced and operationally vulnerable.”
Cllr Alan Harney agreed, saying the current model “isn’t working and people are being failed.” He cited cases where patients left A&E due to long waits, sometimes with tragic outcomes. He also criticised the loss of acute services after the closure of St Brigid’s psychiatric facility in Ballinasloe.
“There is a need to see change,” added Cllr Eileen Mannion. “This service is going backwards rather than forward.”
Responding, HSE Area Manager Ann Cosgrove acknowledged the challenges. While efforts are underway, such as appointing a part-time consultant and planning for an Advanced Nurse Practitioner, she admitted EDs are not suitable for prolonged mental health assessments.
With no psychiatric unit on-site, patients in crisis are transferred to Roscommon, causing delays. Some remain on trolleys for hours or days. PUH also lacks group therapy, and its CAMHS provision is minimal. A Galway-based nurse assesses children during working hours, with limited out-of-hours cover. A new child psychiatry consultant is expected in July, though it’s unclear how often they will attend.
Cllr Parsons questioned the delay in the hospital’s ED expansion, now pushed to late 2025. “We cannot wait,” she said. “The model is inadequate. There’s no permanent CAMHS presence or clinically appropriate space for assessments.”
Cosgrove confirmed the ED upgrade is in procurement, with plans for an improved paediatric area and dedicated family waiting space. She added that the HSE’s 2024–2027 action plan prioritises 24/7 CAMHS services and crisis pathways.
She also announced two SCAN nursing posts for Traveller Health would be based at PUH, noting the community’s high rates of self-harm and suicide.
However, she warned progress depends on adequate staffing and sustained investment, “All guidance and protocols are contingent on appropriate staffing levels.”
