IMT Interview with Dr Leena Naughton

“Now one of the country’s leading providers of mental health services, Highfield Healthcare, will open a new day hospital later this month in the same grounds where one of Ireland’s first-ever psychiatric hospitals was established almost 200 years ago. Peter Doyle reports;

“Highfield Healthcare is highly regarded for the provision of acute mental health treatment and care for adults and older persons with acute, serious and enduring mental health disorders and complex mental health issues associated with neuropsychiatric disorders and dementia,” one of its newest appointments, Consultant Psychiatrist Dr Leena Naughton, told Irish Medical Times (IMT).

“Highfield has a long-established history of providing care that is value-driven and underpinned by person-centeredness and quality,” added Dr Naughton, who joined the Highfield team last October.

Its vision to develop acute mental health services, she added, was being realised with a recent increase in the number of general adult inpatient beds and opening of a second day hospital.

“The organisation is now one of the leading providers of acute and specialist mental health services in Ireland and the only private service delivering the most innovative models of treatment and care in our Day Hospital,” continued Dr Naughton.

‘Long-established history’

Highfield’s “long-established history” can be traced to Dr John Eustace, a physician who worked at the Cork Street Fever Hospital but left his post in 1825 to set up one of Ireland’s first-ever hospitals for the mentally ill on farmland owned by his family in the Whitehall district of Dublin.

Dr Eustace was a Quaker and members of the Christian movement advocated a holistic approach when treating people who had been diagnosed with mental illness.

This philosophy, which was considered radical at the time, has remained central to Highfield Healthcare after the business was begun by Dr Eustace’s sons, John and Marcus, in the second half of the 19th Century.

As stated on Highfield’s website (www.highfieldhealthcare.ie), “the mentally ill have always been with us, but for no family is this truer than for the Eustace family”.

“While the treatment and care of mental illness is, in our day, accepted as one of the duties of a caring society, we must remember, that when John Eustace opened the doors of Hampstead Hospital in 1825, old attitudes were only beginning to change,” the Family History section of the website states.

“The mentally ill were still outcasts, still ‘lunatics’, the majority of them being treated with coercion and restraint. The State’s policy of providing asylums was only developing and it would be a long time before these became caring and therapeutic institutions.”

Caring and therapeutic institutions

Six generations later, the Eustace family runs four private healthcare services with a total of 150 beds, on the same site as the original hospital.

Almost four years ago, in November 2016; the Hampstead Clinic, which provides general adult mental health service, was expanded to include a Day Hospital service with capacity for 12 people.

Two years later, in October 2018, a 12-bed specialist rehabilitation unit (SRU) for people with severe and enduring mental illness was established. More recently, the acute general adult inpatient bed capacity was increased from 11 to 21 beds and a second day hospital opened on the campus.

Dr Naughton said it was envisaged that by 2025 “the configuration of mental health inpatient services will further divide to accommodate a higher volume of acute inpatient services by a reducing number of residents with long-stay mental health issues”.

Day hospital services will hopefully be relocated and/or developed within the community, she added.

Day hospital services

“It is envisaged that the development and recognition of Highfield Healthcare as a centre for learning with established affiliations to the various third level Institutions will be at an advanced stage and supported by state-of-the-art educational and training facilities on campus,” said Dr Naughton.

Key to Highfield‘s future plans is the new day hospital. “This will provide comprehensive psychiatric assessment, diagnosis and integrated treatment tailored to individual needs, and will be carried out by a multidisciplinary team led by a consultant psychiatrist,” explained Dr Naughton.

The range of therapies and activities on offer at the day hospital include a Wellness Recovery Action Plan (WRAP), to help service users discover for themselves simple and safe wellness tools; psychoeducation, to help them understand their diagnosis, pharmacotherapy benefits and side effects and also the impact medicines have on day-to-day life.

Service users will also learn about decider skills, which can help them not only recognise their own thoughts, feelings and behaviours but also how best to monitor and manage them.

By addressing issues like distress tolerance, mindfulness, interpersonal effectiveness and skills for emotional regulations, explained Dr Naughton, decider skills can help control impulsive behaviours such as self-harm, avoidance, and withdrawal. The new day hospital will also carry out social work assessments; occupational therapy assessments; family work, when needed; cognitive behavioural therapy (CBT) group work and one-to-one sessions, if needed; and art and music therapy; and cookery skills also.

Treatment and management of patients

“I was attracted to Highfield Healthcare’s passion towards serving mental illness and dedication to patient care,” said Dr Naughton who completed her medical school training postgraduation in psychiatry in her native India.

“My approach to treatment and management of patients is focused on individualised needs and their complete recovery along with remission of their illness leading to social reintegration and improvement in quality of life,” she added.

“This treatment philosophy will be at the heart of my multidisciplinary team within the Hampstead inpatient unit and new Day Hospital services at Highfield Healthcare.”

Comprehensive experience/cross-cultural psychiatry

Shortly after completing her medical training in India, and before she travelled to Ireland to work for the Health Service Executive (HSE) as a Consultant Psychiatrist, Dr Naughton was part of the research team that carried out the largest epidemiological of Alzheimer’s disease in India.

“I gained comprehensive experience in general adult, child psychiatry, eating disorders, learning disability, addiction and forensic psychiatry through my basic and higher specialist training,” said Dr Naughton, who is fluent in four languages (English, Hindi, Marathi and Urdu). Being multilingual helps her assess patients from numerous backgrounds in their native tongue.

“My exposure to psychiatry in Ireland and India gave me valuable insight and understanding of cross-cultural psychiatry,” added Dr Naughton, who, as a senior registrar, worked as a lecturer at Trinity College Dublin as part of her training in forensic psychiatry.

“I have worked in various HSE services in General Adult Community Psychiatry, as a consultant psychiatrist which helped greatly in developing my approach to treatment, care, ways of working and leading a multidisciplinary team,” she continued.

“Community psychiatry involves day hospital; inpatient and outpatient work at various locations in the catchment area. As a consultant my focus always has been an holistic approach to achieve recovery rather than just remission of illness.”

Election manifesto

With the country on the verge of electing a new Government, the topic of health, including the provision of mental health services, has been a major talking point of the General Election 2020 campaign.

As part of its manifesto, Mental Health Reform (MHR) said Ireland’s mental health services were in a state of crisis and have “suffered from years of significant underinvestment, staffing shortages and access difficulties”.

MHR is calling for all election candidates to pledge substantial investment in Ireland’s mental health services, from 6 per cent of the overall health budget to at least 10 per cent.

The national coalition of organisations campaigning to transform mental health and well-being supports in Ireland also said that 24/7 access to crisis services across the country needs to be improved, while the Mental Health Act 2001 required reform to give adequate protection to people’s rights when they are in hospital for mental health treatment.

Dr Naughton also agreed that the State’s funding of mental health services at present was insufficient. “This is accepted by all stakeholders involved,” she said.

Access to mental health services was becoming more difficult, she continued, because “of unending waiting lists for specialist community care”.

“This causes anguish for those seeking treatment and a worsening of symptoms by the time they finally access our services, meaning increasing chronicity of the illness, their treatment is prolonged, with a poorer prognosis, and the knock-on effect for their caring families and friends,” added Dr Naughton. This, she said, will also impact negatively on waiting-list sizes for other service users trying to access the service because it was taking longer to stabilise and discharge patients.

“Early intervention shortens treatment time and thus opens up more opportunities for new patients,” she explained.

Staffing crisis

She also said the country’s politicians must address the use of recruitment embargoes by the HSE. Staffing levels were at “crisis point”, she said, because under-resourced services were unattractive to new entrants.

The existing pool of mental health professionals was being “cannibalised” by the system, she said, because staff were moving “from one sector to another to plug a hole, creating the same problem in the sector they have just left and the net result is no improvement in staffing levels.

“Recruitment of new professionals from outside the existing base must be a priority and making these opportunities attractive for applicants,” she said.

For referrals please contact referrals@highfieldhealthcare.ie or directly through Clanwilliam GP practice management software.” IMT

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