Some public mental health services are “unacceptable” and might be deregistered 2023

The Mental Health Commission cautioned that certain public mental health services are “simply unacceptable” and might be deregistered.
The independent statutory mental health watchdog reported that buildings, risk management, individual care planning, and staffing compliance ratings were below 70% in its 2022 report.

John Farrelly, the Mental Health Commission’s chief executive, warned that this was essential for meeting minimal mental health treatment requirements. The commission has asked the HSE for an action plan “to address the significant issues raised in its annual report,” notably in the four key areas where compliance was lower.

“Notwithstanding that provider should be generally applauded for the significant work they have undertaken in recent years to improve overall compliance, we can now undeniably say that there are four key areas – premises, risk management, individual care planning, and staffing.

Today’s report emphasizes that badly performing centers must comply with these standards or risk being deregistered. Complying with these and other requirements, which are the minimal criteria, is the least that residents of these institutions deserve.”

when standards are poor, as in 2021 and many years prior,”

Mr. Farrelly expressed worries regarding construction standards. The committee concluded that just 27% of centres met premises regulations. This was down from a third in 2021.

“Most particularly in a number of HSE premises,” Mr. Farrelly said, premises compliance has been low for five years.

“Many of our premises are simply not fit-for-purpose for a modern mental health service,” we have said for years and will continue to repeat until things change. To be clear, a focused, funded strategic capital investment program is desperately needed in our public system,” he said.

The Mental Health Commission visited 66 mental health centers last year. Inspections resulted in 45 enforcement proceedings against 28 institutions, even though over half had compliance rates of 90% or better. This increased from 42 enforcement actions against 20 centres in 2021.

Last year, the commission declared 33 authorized mental health centers overcapacity. 20 minors were admitted to 11 adult mental health institutions. The 32 such admissions in 2021 decreased.

Some mental healthcare practitioners have a “apparent inclination” to institutionalize vulnerable persons, according to the panel. The committee recognized that bigger mental health units were cheaper and easier.

“There is a real risk that we are beginning, as we did in the past, to once again re-institutionalize people who are mentally ill, elderly, or who just do not ‘fit in’ to society,” said Dr. Susan Finnerty, Inspector of Mental Health Services.

“We urgently need to provide all our citizens with rights-based personalised care in their own communities when they need it, or risk, once again, becoming a society that locks away its vulnerable citizens.”

2022 had 2,040 involuntary center admissions, down from 2,549 in 2021. 36% of forced admission applications were from Garda Síochana.