Psychiatrists call on mental health organisations to address information deficit.
Psychiatrists are being hampered in their treatment of patients because there is no centralised data or patient history to call on, a new report has found.
It says many psychiatrists are not providing the best treatment possible in emergency situations because of this. It has called on the main organisations involved in mental health, including the HSE, Department of Health and the Mental Health Commission, to examine the matter as a matter of urgency.
"There is an information deficit, particularly in clinical information," said Dr Larkin Feeney, a co-author of the report and a consultant adult psychiatrist at Cluain Mhuire Mental Health Services, in Dublin. "Many psychiatrists end up seeing patients with no access to their background information."
Dr Feeney told The Irish Timesthat the area of mental health was different from other medical disciplines because it relies very much on information supplied by others. "We cannot do blood tests, cardiograms, etc [in assessing a patient], so we rely on others to tell us."
His study, conducted with fellow Cluain Mhuire psychiatrist Paul Moran, points out that historical information is key to decision-making in mental healthcare and most of this information is currently on paper.
However, as the mental services have moved into the community and towards a multidisciplinary approach, this has led to information being dispersed widely, making it less accessible, particularly in emergency settings or situations.
The study found that more than 80 per cent of psychiatrists questioned said they had had to conduct emergency health assessments within the past year without access to key information.
More than two-thirds said they would have made different decisions in some cases if they had had all the available information.
Lack of information was particularly apparent in liaison and forensic (criminal record history) psychiatry.
An overwhelming majority of psychiatrists (92.4 per cent) said they would welcome an electronic database designed to support emergency mental health assessments.
In their study, the authors point out that mental healthcare is highly information dependent.
"There are many risks that need to be considered in any mental health assessment; these include suicide, violence to the public, violence to staff, mental distress and self-neglect," they say.
The authors say that in many cases the information mental health professionals need is frequently unavailable from patients.
They say this is because in emergency situations the patients are sometimes too unwell, too intoxicated or are "unreliable historians".
Dr Feeney said the change to a community-based service, coupled with the fact that many people now change address frequently, meant that the information needed was being dispersed more widely.
He said some information systems were being developed, but it was unclear exactly how they would work.
In any event, Dr Feeney said, the aim seemed to be to collate information from an administrative viewpoint, in other words to to see how many people attended hospitals, how many appointments were made, etc.
He said there should be a greater emphasis on compiling information on the clinical needs of patients.
Dr Feeney acknowledged that there were fears - which were also expressed by some of the 119 psychiatrists who completed questionnaires for the study - about confidentiality of electronic systems.
However, he said if done right and the agreed type of information was compiled on an electronic system, such a database could be more secure than a paper one.
• The full details of the study are published in this month's Irish Journal of Psychological Medicine.