University Times: Students Feeling Effects of ‘Log Jam’ in College Health Service WithJody Druce

Trinity’s top health official has blasted the under-resourcing of College’s health service, saying that staff are unable to provide care to all of their patients.

Director of College Health Dr David McGrath said that the issues in the health service existed before the pandemic, but since March 2020, “the phones simply never stop”.

Conversations with a number of students have also highlighted the issues with waiting times in the health service.

In an email to The University Times concerning a withdrawn request for information under the Freedom of Information Act, McGrath said: “College Health has the same number of GP Clinical hours that it did before the pandemic.”

“Even prior to the pandemic”, he continued, “College Health was not in a position to deal with all of the medical needs of all students”.

“No College Health Service in Ireland is resourced to do this”, he said. “The phones simply never stop.”

Several students interviewed by The University Times said they were frequently unable to reach the service by phone.

Interviewees gave details of their personal experiences with the service on condition of anonymity.

One first-year student who suffers from ADHD who needed to refill a prescription said they called “at least 30 or 40 times in the space of two days” without getting through. Unable to receive their medication through College Health, the student resorted to going to a GP to renew their prescription.

Another student said they “thought something must be wrong with my phone” after not getting through to the service for several days in a row.

The service employs four full-time physicians, with a psychiatrist working part time.

Making a comparison with the health service at the University of Edinburgh, where McGrath previously served as head of the department, he said: “In Edinburgh, for a student population at the time of 23,000, we had 16.5 full time equivalent GPs.”

Trinity has 4.3 equivalent GPs for 18,000 students.

This equates to almost 4,200 students per physician. College Health also serves Trinity’s staff, which McGrath said is in the range of 2,000 to 3,000 employees.

In the 2020/21 academic year, the service provided over 20,000 appointments.

McGrath said the service attempts to deal with this massive workload by prioritising “potentially serious conditions”. But, “understandably”, he said, “the student who is well and asymptomatic but wants to have, say, an STI screen or a blood test for peace of mind, will consider that their case for an appointment is equally valid”.

One student told The University Times they “understand the incredible strain the service is under”, but wish they had been told immediately to go to a private doctor. Instead, the student tried for over six weeks to arrange an appointment before eventually spending heavily on private healthcare to confirm a diagnosis of carpal tunnel syndrome which now requires surgery.

A “log jam” also exists with student demand for prescription medication.

“We have a very large number of students seeking prescriptions for pre-existing conditions, often with medications that are either unlicensed in Ireland or, if licensed, can only be prescribed by our consultant psychiatrist”, said McGrath.

The student with ADHD mentioned previously was warned by staff within the Child and Adolescent Mental Health Service (CAMHS) that several of their patients have had issues with making appointments and obtaining medication from College Health.

Another student, who suffers from a chronic condition alleviated by prescription medication, was unable to renew their prescription with the service despite weeks of trying, arriving within a day of running out. The problem was only solved when the student asked a friend’s father, who is a doctor, to write a prescription for the required drug.

McGrath said College Health has tried to prevent these kinds of issues by asking international students to bring sufficient medication for the entire semester as well as “letters from their treating doctors transferring their care”.

“Disappointingly, to say the least”, he said, “not a single international student sent us the information prior to arrival”, this year.

On demand for mental health services, McGrath said: “The psychiatrist needs to see those students at risk of self-harm or suicide, as well as those with schizophrenia and severe bipolar disorder and these must take precedence over those with less serious, although distressing and disabling, conditions.”

General practitioners are able to take these less severe cases, but demand for help from those with non-life threatening mental illness cannot always be met promptly.

“If I say to you that an initial consultation with the college psychiatrist is 90 minutes long and the Psychiatrist works three and a half days a week in term time and one day a week in vacation time, you can see the extent of the problem”, he said.

The student with ADHD said they tried to make an appointment with the psychiatrist in October of last year, but was told the next available time was on January 10th.

The student said the fact that the service only employs a single psychiatrist is “outrageous”.

Another student with severe mental health issues said a major problem is the timing of the appointments College Health could offer, with times often during prime lecture hours.

The student, who communicates with the service via email, said response times tend to be between two and three days. They said: “I think College Health’s biggest failing is its administration.”

College Health also carries out an average of 25 coronavirus tests per day and offers vaccination to students and staff that fall into high-risk categories.

In response to some of the examples of student issues with the service brought up by The University Times, McGrath said in an email that of the thousands of appointments College Health schedules, these “seem more than a little unrepresentative”.

Responding to Dr McGrath’s comments, Trinity Media Relations Officer Thomas Deane said: “Trinity is hugely grateful to everyone in the Student Health Centre. Everyone has done a fantastic job, both during the pandemic and more generally.”

“Dr McGrath raises worthwhile and interesting issues and although the situation here is not directly comparable to that in other jurisdictions, it is clear that there is room for improvement”, Deane said. “The opening of a new and bigger student health centre in the coming months is a welcome step forwards.”

College is planning to set up a new health centre in the Printing House Square building, which, after frequent delays and roadblocks over the last two years including the nearly halting effect of the pandemic, is due to open early this year.

Speaking to The University Times at the end of September last year, Project Sponsor Kevin O’Kelly said student rooms wouldn’t be available for a semester-two start because “even if we get it in January, we need it for a month, to bring in all the furniture, the fittings, the bed linen, the beds”.

When complete, alongside the new College Health Service and home for the Disability Service, the building will have space for 250 student beds.

The building will also house squash and racquetball courts and a renovated rifle range, as well as ergonomically sound seminar rooms. The student apartments will be arranged in groups of six ensuite rooms, all connected to a communal kitchen space.

In February 2020, The University Times reported that College’s Commercial Revenue Unit recommended a “€10 per week premium” on rooms in Printing House Square.

However, Neal Murphy, Trinity’s head of accommodation, told this newspaper in September that “with the delays to the project there has been no discussion on PHS rates for some time”.

Correction: 4:24pm, January 25th, 2022 An earlier version of this article incorrectly implied that the College Health Service is not adequately equipped for students with life-threatening mental illnesses or issues to be seen promptly. In fact, students with non-life threatening mental illnesses often have lengthy waiting times to be seen due to the under-resourcing of the service: students with life-threatening illnesses or issues are prioritised for appointments with the service’s psychiatrists.