Concerns raised over condition of psychiatric hospitals

SOME PSYCHIATRIC hospitals are facing a running battle to operate in damp, mouldy and dilapidated facilities, according to the Inspector of Mental Health Services’ latest report. It is contained in the Mental Health Commission’s 2007 annual report, released yesterday.

The inspectorate expresses “serious concerns” about conditions in some units, finds major shortcomings in services for people with intellectual disabilities and criticises the impact of the HSE recruitment embargo on the psychiatric service.

It says the embargo has “greatly impeded” the development of mental health services. At the end of last year, there were over 400 vacancies in areas such as nursing, psychology and social work.

The embargo was lifted in December, but the report says the number of existing vacancies “is quite staggering” in view of the continuing shortage of mental health staff. It points out that over 1,100 people have been in long-stay wards in old psychiatric hospitals for more than a year, where conditions remain “poor”.

“The inspectorate had serious concerns about conditions in Kelvin Grove in St Dympna’s in Carlow [since closed]; St Joseph’s Hospital in Limerick; St Brendan’s Hospital in Dublin, St Davnet’s Hospital in Monaghan, St Ita’s Hospital in Portrane and St Loman’s Hospital in Mullingar,” it says.

“Some wards in other hospitals were drab and institutional and some were dirty. The structural fabric of these hospitals was poor and there was a running battle to keep ahead of damp, mould, falling plaster and peeling paint.”

The report says that the maintenance costs of these old buildings is considerable. “Most of these hospitals are sitting on land banks which represent a rich asset, yet many residents of these hospitals continue to live in inappropriate and unacceptable accommodation. There is so far no firm indication that these assets will be reinvested in mental health services.”

Dr Susan Finnerty, assistant inspector of mental health services, said she was concerned at reported plans to close wards and replace them with large 24-hour supervised residences without adequate rehabilitation services.

“There is a real danger of these facilities becoming wards in the community,” she warned. There are 126 residences caring for 1,480 people in the community.

Meanwhile, Bríd Clarke, chief executive of the Mental Health Commission, highlighted a 25 per cent reduction in the number of involuntary admissions to psychiatric units last year. Last year was the first full year of the implementation of the Mental Health Act 2001, which gives patients the right to an automatic independent review if they are admitted against their will. Some 2,248 reviews, or mental health tribunals, were held last year, which resulted in 11 per cent of orders being revoked.

However, she expressed concern at the 15 per cent increase in patients being regraded from voluntary to involuntary status and said this must be investigated.

Dr Finnerty expressed “great concern” at the lack of services for people with intellectual disabilities. She said about 300 people with intellectual disabilities were in long-stay wards in psychiatric hospitals with little or no intellectual disability services.

Inadequate facilities for children with psychiatric difficulties were again highlighted, with 193 admissions of children to adult psychiatric units last year.

Mental health services always end up at the end of the queue, Opinion, page 15