Physical restraints used on mentally ill
TOO many patients with a mental illness are still subjected to seclusion and physical restraint in psychiatric units across the country, a watchdog report has warned.
There is also too little emphasis on recovery from mental illness, giving patients the right supports and skills to regain control of their lives, the Mental Health Commission warned.
Instead, patients can end up just being "treated" and left to manage their illness, depending on what area of the country they are in, warned commission chairman John Saunders.
Although the concept of recovery rather than simply managing mental illness is now well understood, its availability to patients is uneven, he pointed out.
The kind of service delivered to psychiatric patients is still largely given by psychiatrists and mental health nursing staff with a "significant absence of psychology, social work, occupational and other team members", he added.
Launching the commission's annual report, he said advances in the mental health service were at risk of coming to a halt because of lack of investment and staffing.
Just four in 10 of the psychiatric facilities inspected last year had the right levels of staff and only 60pc had individual care plans for their patients.
The report expressed concern about the ongoing use of seclusion and physical restraint for patients.
Levels of full compliance with the rules on seclusion remain very low and only 33pc of centres met with all the requirements last year – a slight improvement on 2012.
The proportion of approved centres achieving full compliance with the rules on mechanical restraint rose but last year just 68pc met the standard.
The commission also said it was concerned that people can be administered electric shock treatment against their will.
"There is still a most unsatisfactory situation whereby children are being admitted to adult units – there were 91 such admissions in 2013, one in five children," he added.
Areas where services had low compliance included therapeutic services and programmes (49pc); privacy (68pc); premises (30pc); use of CCTV (77pc); staffing (44pc); maintenance of records (52pc) and complaints procedures (67pc).
Commenting on concerns by psychiatrists in the Carlow-Kilkenny mental health region about services and the number of suicides over 18 months, he said the commission, which is to produce a report of its investigation, found the rate was not above normal and was likened to a cluster of such deaths, which can happen.
The commission attached nine conditions to the registration of eight centres last year including Limerick Regional Hospital, Ennis General, Mayo General, Cappahard Lodge, Limerick, St Brigid's Hospital Ardee, St John of God Hospital Dublin, St Joseph's Limerick and the Sycamore Unit, Connolly Hospital, Blanchardstown.
The conditions included some on the use of seclusion and bodily restraint.