Patients sedated improperly, report says


AN INQUIRY established by the State’s mental health watchdog into two psychiatric hospitals has found evidence that intellectually disabled residents were being inappropriately administered tranquillisers to control their behaviour.

The report into standards at St Michael’s Unit, South Tipperary General Hospital, and St Luke’s Hospital, both in Clonmel, also found widespread failures to provide proper standards of care to residents.

The inquiry, commissioned by the Mental Health Commission, was prompted following concerns over the number of fractures suffered by residents at the hospitals.

Among the main findings of the report are:

-Wards were unnecessarily locked

-Seclusion was being used too often

-Patients were forced to wear nightclothes during the day

-No comprehensive needs assessments or care plans for residents

-Lack of needs-based therapeutic or recreations activities

The report did not find evidence that the number of fractures among residents were non-accidental. However, it said environmental defects were not properly addressed, increasing the risk of injury to patients.

The report sets out a series of time-bound steps for both hospitals – which provide care to just over 180 patients – to meet in order to comply with regulations.

Failure to meet these steps could allow health authorities to close, or de-register, the hospitals.

Chairman of the Mental Health Commission Dr Edmond O’Dea said it would work with all interested parties to develop quality mental health services in south Tipperary. “Government policy is to move towards the closure of institutions such as St Luke’s and to move towards a community-based care and treatment model,” he said.

“For this to happen, community mental health services must be provided and funded . . . even in these difficult economic times.”

The report itself was highly critical of the care provided to intellectually disabled residents, who accounted for a third of long-stay patients.

In some wards, it found evidence that patients were being administered tranquillisers – benzodiazepine – to control their behaviour in the absence of needs-based therapeutic and recreation activities.

On the issue of the overuse of locked wards, it found there was no policy governing this practice.

The report says the lives of residents were “impoverished” because their choices, freedoms and opportunities were restricted more than was necessary for their care and treatment.

In staffing, it said consultant psychiatrists had limited time for long-stay ward responsibilities because of time commitments.

Agreed nurse staffing levels were often not achieved because of unexpected absences and a 20 per cent shortage of trained nurses.

At St Luke’s Hospital, it found that in general it was unsuitable as a home or for the provision of person-centred care. Most dormitories were bleak, with few personal items and little personal space.