Minister publishes Annual Report of the Inspector of Mental Hospitals
Mr Micheál Martin, TD, Minister for Health and Children, today (29 July, 2000) published the Annual Report of the Inspector of Mental Hospitals for 1999 and laid copies before both Houses of the Oireachtas and forwarded a copy to the President of the High Court.
In his report for 1999, the Inspector notes the continuing decline in the number of patients in psychiatric inpatient facilities, from 5,101 at the end of 1998 to 4,768 at the end of 1999. There were more than 24,000 admissions to these facilities in 1999 of which approximately 6,700 were first admissions. The proportion of patients being admitted to acute psychiatric units in general hospitals continued to increase and in 1999 accounted for thirty-five per cent of admissions. A further fifteen per cent were admitted to private hospitals. The number of involuntary admissions at approximately 2,400 remained constant at ten per cent.
The Inspectorate continued to fulfil its statutory duty to visit each catchment area mental health service at least once during the year and the private hospitals and Central Mental Hospital twice a year. The report published today is a summary of the Inspector’s findings following his inspections in 1999. While the majority of services were given two to three days notice prior to the inspection, a number of inspections were unannounced.
A number of welcome developments were reported in many of the health board regions during 1999. Examples in the Eastern Region included the opening of the new acute psychiatric unit at Tallaght General Hospital, a nine-bed sub-unit for the psychiatry of later life at St James’s Hospital, a day hospital on the campus of St Vincent’s Hospital, Fairview and two new health centres in the Kildare service. In other health board areas a new sector headquarters in Bailieboro, Co Cavan was welcomed, as was the opening of a new community residence in the North Cork service. The North Lee catchment area was on the threshold of its most important development for years – the opening of the new acute psychiatric unit in the Mercy Hospital. (The unit opened in April, 2000). Although the Inspector acknowledged the progress that has been made in the provision of acute units in general hospitals, community mental health centres, day hospitals and community residential facilities for persons with mental health disorders, he stated that the rate of progress needs to accelerate.
Concern was expressed at difficulties recruiting qualified psychiatric nursing personnel, which were particularly acute in the Eastern region. However, concerted marketing campaigns undertaken by the Nursing Careers Centre and the schools of nursing around the country have since succeeded in filling a record 242 training places in psychiatric nursing and 156 places in mental handicap nursing. The Schools of Psychiatric Nursing in Letterkenny, Limerick and Waterford, which did not proceed with intakes in 1998 due to the low number of successful applicants accepting places, had all substantially increased their intake of students in 1999.
In his latest report, the Inspector also welcomed the publication of a new Mental Health Bill in December, 1999. The Bill provides for the independent and automatic review of each decision to detain a patient in a psychiatric centre and puts in place mechanisms by which the standards of care and treatment provided in psychiatric inpatient facilities can be supervised and regulated. A Mental Health Commission is to be set up to act as an independent agency to raise standards and practices in the delivery of mental health services and to ensure that the rights of detained persons are protected. Through mental health tribunals, it will provide for an independent review of decisions to detain patients by arranging for an independent assessment by a consultant psychiatrist of the appropriateness of such decisions.
Concern was again expressed by the Inspector at the lack of multidisciplinary teams in many mental health services, particularly in the area of psychology and social work services. The Department provided additional resources to health boards this year for improvements in these services. The Inspector also highlighted a number of other service and quality of care issues which were raised with individual service providers. These issues will continue to be pursued with a view to bringing about the improvements required.
Commenting on the publication of the report, Minister Martin said “I welcome the publication of the Report of the Inspector of Mental Hospitals for 1999 and acknowledge the crucial role that the Inspectorate, as an independent body, plays in providing an accurate and detailed account of services in the mental health sector throughout the country. The report shows that much still needs to be done in the provision of comprehensive facilities and services and it is my intention to consult with the health boards and to facilitate them in as far as possible in bringing about the improvements and developments identified by the Inspectorate.”