THE STATE’S mental health inspectors have warned that wards in a number of psychiatric hospitals are “unfit for human habitation” and need to be closed down as a matter of urgency.
They have also found evidence of dysfunctional management in at least one hospital and untrained staff in other centres being used to administer highly specialised forms of treatment such as electroshock therapy.
The findings are contained in reports by the Inspectorate of Mental Health Services on the State’s 63 psychiatric hospitals and mental health facilities, which accommodate about 2,700 people.
While inspectors found improvements across a number of hospitals, some of the worst conditions were uncovered in Victorian-era psychiatric hospitals which health authorities have been planning to close for 20 years.
Among the findings were:
Two wards in St Loman’s Hospital, Mullingar, were in “poor condition and unfit for human habitation and should be decommissioned as a matter of urgency”, while other wards were “dilapidated, desolate and depressing”.
At St Ita’s in Portrane, Co Dublin, they said 125 people were being forced to live in “appalling conditions” and it was “difficult to convey the extent of dilapidation”.
“Long corridors in poor conditions, toilets with no privacy, paint peeling, mould in showers, broken furniture, ill-fitting doors, cramped dormitories, the smell of urine, poor ventilation and a bare drab environment were clearly evident.”
In St Brendan’s in Dublin, patients were wandering around “apparently aimlessly” in one ward while overall the centre was found to be in breach of over half of the care regulations.
It “continued to be of concern that residents remain accommodated, cared for and treated in such unsuitable premises”.
There were also concerns over standards in acute units of general hospitals, which are held up as the future for acute psychiatric care. The Mater hospital’s acute psychiatric unit in Dublin, for example, failed to comply with rules over the use of electroconvulsive therapy, mechanical restraint and seclusion.
Inspectors also found a significant number of children had been admitted to the adult psychiatric unit of the Mid Western Regional Hospital, Limerick – this despite long-standing concerns that the practice was inappropriate and counter-therapeutic for children.
Some of the most serious breaches in standards were found at Cappahard Lodge, a former public nursing home in Ennis, Co Clare, now a 35-bed centre for psychiatric care of older people. Inspectors said there was a lack of managerial and clinical leadership at Cappahard which resulted in patients not receiving active or timely reviews of care. The breaches in standards were so serious that inspectors revisited the facility within three months and reported significant improvements.
These findings will form part of an annual report by the Mental Health Commission, the State’s mental health watchdog, due to be published next year.
Responding to the findings, Minister of State with responsibility for mental health John Moloney said the standard of accommodation in some hospitals was unacceptable.
He insisted money would be made available to redevelop facilities over coming years. “I acknowledged that things are bad. I’ve spent the last 15 months going around the country and visiting many of these facilities. You can’t stand over some of them,” he said.
Mr Moloney said he had secured a €43 million capital programme in last month’s Budget – to be funded from the sale of mental health assets – to help build or refurbish accommodation. No spokesperson for the HSE was available for comment.
While health authorities have claimed in the past that money raised from the sale of psychiatric hospital lands would be ring-fenced to modernise services, this has not always been the case. In at least one case – St Loman’s in Mullingar – money raised through the sale of hospital lands had not been reinvested in local mental health services.