Efforts to reopen beds at an emergency adolescent mental health service by September "are absolutely down to the wire", a manager at the Health Service Executive has said.
Staff shortages at Linn Dara in Dublin led the Health Service Executive to temporarily close almost half of its 24 beds, provoking an outcry.
Mary O'Kelly leads the HSE's Primary Care services in Dublin South, Kildare and West Wicklow.
She told the Sub-Committee on Mental Health that services right across the capital are suffering staff shortages because of soaring property costs.
One in four nursing graduates "don't take up a job" in nursing in Ireland, Ms O'Kelly said.
And she pointed to the additional pressures of "competing internally" with other HSE units to hire those who do.
"We're really at a disadvantage geographically" as a result of house prices and accommodation shortages in the capital. she said.
Ms O'Kelly told Sinn Féin TD Mark Ward that there needs to be "weighting for staffing who have to pay over the odds" to incentivise them to take jobs in Dublin.
Linn Dara provides in-patient services for the Child and Adolescent Mental Health Service [CAMHS].
Serving the east of the country, its 24 beds are used to treat "complex and high dependency cases", Jim Ryan, Head of Operations at HSE Mental Health Services, said.
Because of staff shortages, the HSE recently temporarily closed 11 beds.
Ms O'Kelly described as "stark" the fact that nursing staff levels at the facility have fallen below 50%.
Just 24 of the 51 nursing positions are filled, she told Neasa Hourigan, Green Party TD.
Ms O'Kelly said that 30 graduates have been put on a panel for mental health posts in the HSE, but they can choose which service they want to work in.
There is also a specific recruitment drive underway, and agency staff will continue to be used at Linn Dara, she said.
But given the fact that placing someone can take four months, she accepted that it will be a challenge to get staff in place in time to reopen beds by September.
"We are absolutely down to the wire," Ms O'Kelly said.
However, Kevin Brady, Head of Mental Health Community Healthcare for Dublin South, Kildare and West Wicklow, insisted that he is "very hopeful of reopening" the beds in September.
"That's the plan", he told Gino Kenny, Solidarity-PBP TD.
Prof Brendan Doody, Clinical Director of Linn Dara, said that the decision to close the beds was made "with great regret".
And he accepted Deputy Ward's concern that closing those beds increases the risk of children being admitted instead to adult wards.
Prof Doody noted that more than 75% of in-patient staff are nurses, adding that, "rather than leaving the service", nurses are being drawn to other parts of the HSE.
He called for "workforce planning" to prevent some units - such as Linn Dara - losing out, when new facilities "[take] staff from other services".
Linn Dara has eight beds for specialist emergency treatment of eating disorders, and two beds for intensive care.
"There has been a huge increase in the number of people presenting specifically with eating disorders," Prof Doody told the committee.
He also said that younger children are presenting with the disorders, with 15% of admissions to the facility being for children aged 13 or under.
Most of those were struggling with eating disorders, he said.
In 2019, there were 47 referrals to HSE specialist community teams for these conditions, Prof Doody said.
Within two years this had increased four-told, rising to 197 in 2021.
And he said that in Tallaght Hospital there has been "a five-fold increase" in cases of eating disorders over eight years.
"The pandemic accelerated this increase", he said, noting that the experience is being mirrored internationally.
