• Clodagh Meaney

Mental Health patients 'fundamental human rights are being over looked' at Irish care centres

A report found that more than half of all centres were non-compliant with a number of regulations.

The fundamental human rights of mental health patients are being over looked in Irish care centres, that's according to a report by the Mental Health Commission published today.

The report said that too many residents still being treated like "second-class citizens," with concerns including national compliance with regulations, unclean premises, a lack of meaningful care plans, seclusion and an increase in the use of physical restraint, were all highlighted.

Almost half (48 percent) of all approved centres were non-compliant with the regulation on individual care plans, with 58 per cent non-compliant with the regulation on general health and 48 percent of centres non-complaint with the regulation of maintenance of records.

17 of centres were also found to have the continued presence of ligature points.

In total, 69 percent of approved centres were non-complaint with the regulation on premises. Of those 11 percent were risk-rated as ‘critical’.

33 percent noncompliant because they were unclean. Findings included a dirty seclusion room; unclean bathroom facilities, including discarded cigarette butts; litter in outdoor area; kitchen areas that appeared contaminated. Urine-soaked panels and floors were also observed, while offensive odours were observed in nine facilities.

79 percent of the centres that used seclusion, were non-compliant. Seclusion can be used by Doctors and Nurses after an assessment if it is in the patient's best interests to prevent them from harming themselves or others.

Every time a patient is secluded, staff are required to keep excellent records, and should never seclude patients if there are difficulties in the approved centre, such as not enough staff on duty.

Half of all Child and Adolescent Mental Health Services (CAHMS) also use seclusion, and of those centres there was 79 percent non-compliance.

In 2019, 58 centres used physical restraint, that's an increase from 2018's 53 centres. Of these, 89 percent were found to be non-compliant.

48 percent of centres were found to be non-complaint with the regulation on individual care plans.

Of those centres, 74 percent did not develop appropriate goals for residents. In some individual care plans, there were no goals documented.

In other care plans ‘big picture’ goals were stated such as: ‘maintain physical health’, ‘improve mental health’, and ‘get accommodation’.

During 2019, there were 98 child and adolescent beds available nationally. Those beds were located in Dublin, Galway and Cork, only. During that time 54 children and young people were admitted to adult units.

“The Commission has consistently and repeatedly underlined the failings in our mental health system year after year, yet these shortcomings are yet to be acted upon in any meaningful way."

“The report evidences that our mental health service users are still being treated like second-class citizens in this country. We may have made huge strides since we started to shut down the old mental hospitals, but it’s abundantly clear to the Commission that we haven’t come far enough," he said.

"The basic human rights of many residents continue to be overlooked. While our enforcement proceedings are resulting in some progress, it is clear that there are a number of matters that are key to addressing these issues."

Inspector of Mental Health Services, Dr. Susan Finnerty. said that a significant number of premises are no longer suitable and need to be replaced."

“Of the 69% of inpatient units that were non-compliant with this regulation, 33% were dirty. Findings included a dirty seclusion room, unclean bathroom facilities, litter in outdoor areas and offensive odours. Ten approved centres were not adequately lit, heated, or ventilated."

"This is an ongoing problem, year on year. It is simply not good enough that people who are extremely unwell are forced to reside or recover in wards or rooms that are unclean, malodorous or poorly maintained," she said.

“Continued poor compliance with the regulation on individual care plans needs to be tackled on a number of fronts."

“The Commission has written formerly to the HSE seeking an action plan to address the significant issues raised in their report, and particularly around premises, seclusion and restraint, staffing and individual care plans," she added.

“Staff were observed to be kind, compassionate and caring towards residents, and this is something that we have all seen once again during the recent pandemic,” she explained.

The Chairperson of the Mental Health Commission, John Saunders, added that the report provides clear evidence that the new government must commit to ensuring the full implementation of the refreshed mental health policy.

“If we want to see real change, the new government must implement the refreshed policy in full and this must be met with ring-fenced and prioritised funding,” he said.

“It is also critically important that we push forward and repeal and replace the current Mental Health Act to reflect a human rights approach. These reforms must include enhanced powers so the Commission can appropriately regulate all community, online and other forms of care and treatment. "

If you have been affected by any of the themes in this article, please reach out:

Aware - 1800 80 48 48

Samaritans - 116 123

Pieta House - 1800 247 247

© 2020 by EMPWR

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