Report of the Inspector of Mental Hospitals
Mr Brian Cowen, TD, Minister for Health and Children, today (10 November, 1998) laid the Annual Report of the Inspector of Mental Hospitals for 1997 before both Houses of the Oireachtas and forwarded a copy to the President of the High Court.
The Inspector has a statutory obligation to inspect every psychiatric hospital and unit in the country at least once a year. The report published today is a summary of the Inspector’s findings, following his inspections in 1997.
In his report for 1997, the Inspector refers to the steady progress that has been made towards improving the quality of mental health care in this country. The Inspector points out, however, that the rate of progress in upgrading unsatisfactory accommodation or providing alternative community residential accommodation, as well as the development of acute units in general hospitals, has been dictated by the availability of capital funding. In order to address this problem, the Minister has provided £7 million in capital funds in 1998 which will accelerate the provision of acute psychiatric units in general hospitals. For example, the Minister has included in the capital programme provision for units at Portlaoise, Kilkenny, Sligo, Nenagh, Ennis, St Vincent’s, Elm Park and Beaumont Hospital. Capital funds have also been made available for the provision of additional community based facilities throughout the country including facilities for older people with mental health problems.
The Inspector refers to the unsatisfactory admission facilities at St Ita’s Hospital in his report. A capital grant of £550,000 has been provided by the Minister to enable these facilities at the hospital to be upgraded, pending the construction of a new 60-bed acute psychiatric unit at Beaumont Hospital. The Eastern Health Board’s development plan for St Joseph’s Mental Handicap Service, on St Ita’s Hospital campus, was welcomed by the Inspector. It deals with the commissioning of four community houses which will facilitate the closure of a number of units in the complex and will allow staff to provide the highest quality care to patients in the most appropriate setting. The Minister has announced a £13m project, which will be funded jointly by the Department of Health and Children and the Eastern Health Board, which will provide alternative and refurbished accommodation for persons with a mental handicap currently accommodated in facilities on the St Ita’s Hospital campus.
The slow rate of progress in providing quality, general hospital based care for acute psychiatric illnesses in the Dublin area was highlighted by the Inspector. This deficit will be addressed through the opening of the acute psychiatric unit at Tallaght General Hospital which is being actively pursued by the Eastern Health Board and the provision of acute units at St Vincent’s Hospital, Elm Park and Beaumont Hospital. As part of the development of James Connolly Memorial Hospital, the Eastern Health Board intends to construct an expanded acute psychiatric unit which will meet the needs of the catchment area.
Community services were expanded in many of the health board regions during 1997 and examples of these developments include the opening of a high-support residential facility and mental health centre in Rathdowney, Co Laois; a community residence for patients with a mental handicap, formerly resident in Our Lady’s Hospital, Ennis, in Kilrush, Co Clare; a day hospital and sector headquarters in Bailieboro, Co Cavan; a new high-support residence in Tipperary Town and St Colman’s high-support residence in Macroom, Co Cork.
The Inspector comments favourably on the major expansion of the diploma-based Programme of Nursing Education and Training which was substantially expanded in the psychiatric nursing service and introduced for the first time in the mental handicap nursing service. The provision of a new Bachelor of Nursing Studies degree is also welcomed.
As part of the inspections carried out on mental health facilities, the Inspectorate of Mental Hospitals has prepared a checklist of what constitutes satisfactory clinical and administrative practice in the mental health services. The Inspector has prepared Guidelines to Good Practice which are based on this checklist and these have recently been circulated to all providers of mental health services in the country.
The Inspector expresses concern about the availability and quality of forensic services to the prisons and the courts. This matter is being addressed by the Department of Health and Children, the Department of Justice, Equality and Law Reform and the Eastern Health Board and it is hoped to bring about improvements in this area in the near future.
Commenting on the publication of the report, Minister Cowen said
“The Inspector of Mental Hospitals has, over the past decade, played a crucial role in raising standards in the mental health services in this country. I acknowledge the influence of the Inspector of Mental Hospitals and his team in improving the quality of our mental health services and in the promotion of good practice. The improvements achieved in 1997 are documented in this latest report. While these improvements are welcome, I fully acknowledge that much remains to be done to improve both physical facilities and services within the mental health sector. It is my intention to continue with the initiatives which I have commenced in 1998 so that we improve the rate of progress in the provision of a modern mental health service”.