Mental health services in danger of ‘moving backwards’

Mental health services are in danger of “stagnating and moving backwards”, the State’s watchdog for psychiatric care has warned.

A combination of staff shortages and slow changes to work practices means progress in some areas has ground to a halt, the Mental Health Commission said.

“While some service providers are making progress toward providing a truly modern mental health care service, there are many others that are struggling,” said John Saunders, chairman of the commission.

“We are moving to a dangerous area of stagnation in terms of progress in the development of mental health services in Ireland.”

Mr Saunders was speaking at the launch of the commission’s annual report which shows key areas of service provision fall below what the watchdog body deems as acceptable.

Some 44 per cent of services complied with staffing requirements last year, while 60 per cent met regulations in relation to individual care plans for patients.

Patricia Gilheaney, the chief executive of the commission, said the level of adherence to these statutory regulations was not acceptable.

“Seven years on, we should be at the stage where we’re moving on and aiming for higher standards.”

In all, there are a total of 9,000 staff working across mental health services in the State , although official policy states there should be 12,000.

Mr Saunders said service providers were under massive pressure to do more with less and that staffing issues were in danger of impacting on basic services.

He said the staffing of community mental teams, in particular, was a priority but significant gaps remained.

A Vision for Change, the blueprint for the development of mental health services, was adopted as official policy in 2006 and envisaged the development of a recovery-oriented services.

While it found there was “considerable commitment” to the policy, it was being implemented unevenly and inconsistently across the State.

Other areas of concern include the over-use of seclusion and physical restraint, as well as the admission of children into adult psychiatric units.

Last year a total of 91 children were placed in adult psychiatric units, despite warnings from the commission that practice should only occur in extreme cases.

Ms Gilheaney also called for the commission to be given powers to inspect community-based services, such as nurse-supervised residences and other settings.

While the commission may inspect these services from time to time, it has no statutory role and care regulations do not apply to these settings.

A report from the Inspectorate for Mental Health Services expressed concern in recent days that many of these nurse-supervised community residences are institutional in nature and have limited access to therapy and support.