PEOPLE WITH serious mental health problems are still being admitted to Victorian institutions which are unfit for purpose, the State’s mental health watchdog has warned.
Despite the Government’s 10-year plan to modernise psychiatric services, the inspector for mental health services said hundreds of people are detained in institutions without human rights standards or frequent inspections.
Dr Patrick Devitt said these facilities were a “fertile ground for abuse or neglect” and were relics of an era when the solution to mental health problems was to confine people away from society.
He said the inspectorate had recommended the continued operation of 15 Victorian institutions on the condition that they provide continually updated and detailed plans for the provision of more suitable accommodation.
His comments are contained in the Mental Health Commission’s annual report for 2008 which was published yesterday.
While some improvements have been achieved, overall Dr Devitt said the level of compliance with new rules and regulations for care standards was disappointing.
The inspectorate found that many clinicians and consultants tended to view rules as “mere technicalities” rather than legal requirements and defended their practice on the basis that “we’ve always done it this way”.
Some long-standing problems, such as the admission of children into adult psychiatric hospitals, appear to be growing worse.
In 2008, there were 247 admissions of children to adult units, an increase of 30 over the previous year. Of this overall figure, six admissions to adult units were involuntary or against the will of the child.
The inspector said this practice was “inexcusable, counter-therapeutic and almost purely custodial”, because clinical teams were not qualified to treat children or adolescents.
He also highlighted cutbacks to community-based services which, he said, will create more problems in the future.
However, Dr Devitt said cutbacks also create an opportunity for more coherent thinking on what services should be provided.
“There is still the potential for great improvement. This is evidenced by the continuing high calibre of mental health service staff of all disciplines. The commitment shown by such professionals is critical to the successful transition from archaic institutions to community care,” he said.
Dr Devitt recommended the Health Service Executive (HSE) establishes a directorate for mental health to ensure there is real and fundamental change in the sector.
Chairman of the Mental Health Commission Dr Edmond O’Dea also said it was vital the Government sticks to its commitment to ring-fence proceeds of the sale of old mental health institutions for developing community services.
Responding, the HSE said it “welcomed” the report but, pointedly, did not respond to calls by the commission for a directorate to be established to oversee mental health services.
It said it was committed to ensuring all the statutory requirements on standards of care and pointed to progress being made providing new child and adolescent in-patient beds, as well as the development of consultant-led services.
The Irish Mental Health Coalition expressed alarm at the “sustained lack of improvement” in services.
It said the absence of professional teams and therapeutic services means patients are not getting basic treatment and services.
The coalition added that new legislation was needed to guarantee that the dignity of service users was preserved and that their fundamental rights were protected.