Lawyers, psychiatrists paid €50m to review mental health detentions

Lawyers, psychiatrists and others have been paid almost €50 million for reviewing decisions to detain mental health patients in hospitals involuntarily over the past seven years, new figures show.

The sums paid for professional fees and expert reports at mental health tribunals have grown by 20 per cent since 2011 as the number of people committed involuntarily over the period rose.

The number of court challenges to detentions has increased three-fold over the period. The tribunals, which review cases of involuntary detention, are held in private and there is no public scrutiny of their work.

The Mental Health Commission, which has responsibility for appointing tribunals, has said it cannot review their operation or allow media access to hearings because of the legal requirement for privacy.

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Last year, there were almost seven involuntary admissions a day. The 2,414 involuntary admissions recorded in 2016 represented a 13 per cent increase in five years.

While unable to identify the reasons for this increase, the Commission said involuntary admissions should be a “last resort intervention” and should only follow community-based interventions.

Family members account for almost half (44 per cent) of all involuntary admissions, down from 69 per cent a decade ago.

The Commission has expressed concern that applications from gardaí continue to rise, from 23 per cent in 2015 to 25 per cent last year. It said the authorised officer scheme for processing involuntary admissions needs to be reviewed.

The Commission, which has responsibility for appointing tribunals, has released details of the payments it makes to tribunal members on foot of a Freedom of Information request.

The figures show a 20 per cent rise in tribunal-related payments, from €6.4 million in 2010 to €7.7 million in 2015 and 2016.

Payments are made in a number of categories to: lawyers who chair tribunals; consultant psychiatrists; lay members; psychiatrists who provide independent medical reports; and lawyers appointed to represent the interests of people brought before tribunals.

Some recipients receive payments under more than one category. The highest figure listed for last year was the €72,632 paid to Michael Brendan Lynch, a psychiatrist in Co Kerry, for medical reports and work as a consultant member of tribunals.

The biggest single payment for consultancy alone went to Brian O'Shea, at €67,026, while the largest payment to a lay member of tribunals was €21,168 paid to Fintan Wallis. Limerick solicitor Alec Gabbett was paid the highest amount, €41,096, for chairing tribunals.

The function of a mental health tribunal is to review a decision to commit a person involuntarily, in accordance with the 2001 Mental Health Act. Those facing committal are given free legal representation.

Some 2,079 tribunals were held last year, 7 per cent more than in the previous year. Almost half of all orders to commit were revoked before hearing. Last year, 145 decisions were appealed to the Circuit Court.

The Commission says it is embarking upon major recruitment and training programmes for the appointment of panels for mental health tribunals. This occurs on a three-yearly cycle.

Membership of a tribunal comprises a chairperson, a consultant psychiatrist and a lay person. Decisions have to be made within 21 days of person’s detention.