Vulnerable psychiatric patients living in ‘mini institutions'

Hundreds of vulnerable psychiatric patients who were moved out of mental hospitals over recent decades are living in “mini-institutions” in the community with limited access to health and care professionals.

A report by the State's mental health watchdog estimates that there are at least 115 supervised hostels run by the Health Service Executive which accommodate about 1,500 patients, although the watchdog was unable to find a reliable figure.

In a review of these hostels, the Inspectorate of Mental Health Services expressed concern that:

Many were too large and dominated by institutional practice, with limited access to care and therapy.

Major variations in weekly rent charged to residents, ranging from less than €50 a week to more than €150 a week in some areas.

Some buildings were not fit for purpose and residents were left living in very poor conditions.

These 24-hour hostels were established over recent decades to accommodate patients who could be relocated from outdated mental hospitals.

Regulations

There are no statutory regulations, guidelines or codes of practice in relation to care provided in these residences.

“It appears that in some cases whole long-stay wards were transferred to large buildings in order to speed up the closure of psychiatric hospitals,” according to a report by Dr Susan Finnerty, assistant inspector of the mental health body.

“It is difficult to see these residences as anything but wards in the community with all the disadvantages of institutional care.”

Official policy

Official mental health policy states that these hostels should have a maximum of 10 beds to help foster a non-institutional environment.

However, almost three-quarters of those inspected over recent years had in excess of this number. Some had between 20 and 30 beds.

The report found encouraging evidence that multidisciplinary individual care plans had been drawn up for residents in two-thirds of residences.

But just under half of residents did not have access to psychology services, while just 58 per cent had access to occupational therapy.

John Saunders, the chairman of the Mental Health Commission, said yesterday these hostels appeared to be "mini-institutions" in the community and expressed concern that there was no definitive figure for how many patients resided in them.

The campaign group Mental Health Reform said it was concerned at gaps in mental health supports.