'Fundamental rights' of vulnerable people being breached in mental health services

A report has found the number of children admitted to adult units increased last year

'Fundamental rights' of vulnerable people being breached in mental health services

Undated file photo of a woman holding her head in her hands | Image: David Cheskin/PA Wire/PA Images

A new report says "major transformational change" is needed in the provision of mental health care services.

The Mental Health Commission's annual report for 2017 suggests that without change, Ireland will continue to provide a level of "unsafe and substandard" services.

The commission says the fundamental rights of vulnerable people who require such services are being breached.

It also found that "a disturbingly high number" of in-patient units were dirty and poorly maintained, with associated implications for infection control.

While over 1,300 vulnerable adults with mental illness were accommodated in community residences that were unregulated, mostly institutionalised settings with little or no rehabilitation or prospect of moving to more independent living.

"These people appear to have been forgotten by both the mental health services and by society", the report notes.

'Glaring and inconsistent standards'

John Saunders, chairman of the Mental Health Commission, says: "The commission is now calling on the Government with the Health Service Executive, as the statutory provider of services, to initiate a major transformation programme to deal with the service issues highlighted in this and previous reports of the commission."

He warns: "There is a glaring and inconsistent pattern of standards in service provision.

"The lack of any real progress and commitment on these matters undermines the fundamental human rights of people using mental health care services".

The issues highlighted include the inappropriate admission of children into adult mental health in-patient services, inadequate staffing and variable funding in community child and adolescent mental health services.

The number of children admitted to adult units increased from 68 in 2016 to 82 in 2017.

The report also highlights the "widespread use" of restrictive practices, such as seclusion and physical restraint, as a normalised behaviour in services which lack sufficient numbers of staff and/or appropriately trained staff.

'Non-existent or slow progress'

Mr Saunders adds: "Now more than ever, it is necessary to address systemic issues that hamper the delivery of services and the development of newer, more appropriate ones.

"Progress in many significant areas has either been non-existent or slow, leading to the continued provision of poor quality services for people who use mental health services and their family members.

"Reform of the Mental Health Act 2001 is now a matter of urgency as significant numbers of people are now using unregulated mental health care day and residential services. This situation increases dramatically the risk of abusive or neglectful incidents occurring".

Dr Susan Finnerty, inspector of mental health services, says: "While there were some areas of the mental health service that provided good care, I have a number of concerns about the provision of mental health services in Ireland.

"Of great concern is that I found the services for children and adolescents were generally inadequate, poorly funded and not responsive to the needs of young people and their families."

These issues included the difficult process of sourcing a bed for a child or adolescent, especially in an emergency situation, which Dr Finnerty labels as "frustrating, time consuming and often resulted in a young person being admitted to an adult mental health unit."

Overall, compliance with regulations and rules has only improved by 2% since 2016.