February 19, 2010

CARL O'BRIEN Chief Reporter

THREE LARGE psychiatric hospitals have been warned they could face closure unless they provide detailed plans to improve conditions for residents forced to live in “inhuman” conditions.

The State’s mental health watchdog, the Mental Health Commission, is understood to have written to the hospitals requiring them to provide detailed plans to address shortcomings in care by this week.

A spokesman for the Mental Health Commission declined to comment on the matter or say which hospitals have been requested to improve their quality of care.

The move follows visits by the Inspectorate of Mental Health Services which found that wards in a number of older psychiatric hospitals were “unfit for human habitation”.

The commission is obliged under law to take “all reasonable steps to protect the interests of persons detained in approved centres” under the Mental Health Act (2001). This includes registering only those facilities which it is satisfied provide an acceptable level of care or accommodation.

Unless the hospitals immediately address shortcomings in care or accommodation, the commission has the option of attaching mandatory conditions, or de-registering them entirely.

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.

The harshest criticism centred on St Loman’s hospital in Mullingar, St Ita’s in Portrane and St Brendan’s in Dublin. Among the inspector’s findings were that:

  • Two wards in St Loman’s hospital 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, a total of 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, a smell of urine, poor ventilation and a bare drab environment were clearly evident.”
  • In St Brendan’s, 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. Conditions in some areas “continued to be of concern that residents remain accommodated, cared for and treated in such unsuitable premises”.

These findings are contained in reports on visits by the Inspectorate of Mental Health Services on the State’s main psychiatric hospitals and mental health facilities during 2009.

There are more than 60 psychiatric hospitals or in-patient facilities in the State which accommodate about 2,700 people with mental health problems. Of this, about 15 facilities are old psychiatric institutions.

The commission has been calling for the closure of these facilities for some time.

It criticised the lack of progress in this area in a recent commentary timed to coincide with the fourth anniversary of A Vision for Change , the Government’s policy document on mental health.

In this, it called for the introduction of a revised plan for reform of services which would include real and detailed targets, timelines, resources and assigned responsibility.

However, it welcomed plans announced by Minister of State for Mental Health John Moloney to invest some €43 million to help modernise the sector. This money has been raised from the sale of lands from psychiatric hospitals in recent years.

Accessibility