Latest news with #JimLucey
Irish Independent
31-07-2025
- Health
- Irish Independent
‘Profound decline' in number of people being restrained in Irish mental health services, report finds
Restrictive practices include physically restraining someone or secluding them in a room and not allowing them to leave. The report was published by the Mental Health Commission (MHC), the independent regulator of mental health services in Ireland. It shows the total of 'restrictive practice episodes' in approved mental health centres fell significantly between 2018 and 2024. Over that seven-year period, the use of physical restraint and seclusion fell by 91pc in Child and Adolescent Mental Health Services (CAMHS). The use of mechanical restraint on children – using devices or bodily garments to restrain someone – was banned by the MHC in 2023. Professor Jim Lucey, the author of the report and inspector of Mental Health Services, said: 'Children are specifically protected from restrictive practices in Irish mental health care through a human rights-based approach, acknowledging their particular vulnerability to trauma and harm from restrictive interventions. 'Seclusion and physical restraint can have adverse implications for their emotional development. This approach, underpinned by the principles of trauma-informed care, has been further enhanced by the revised regulations.' There was a 'profound decline' in the number of restrictive practice episodes in CAMHS over the seven-year period, from 2,608 in 2018 to 238 in 2024. 'Our regulatory changes and initiatives, coupled with the commitment of leadership and staff to person-centred, therapeutic care has been instrumental in accelerating the downward trend in restrictive practice use in Ireland since 2022, and building on a significant decline observed since 2018,' MHC chief executive John Farrelly said. The findings of the report have been welcomed by the MHC as a 'positive result' for mental health services, with evidence showing restrictive practices are 'counterproductive' and do not help to reduce levels of violence and aggression in approved treatment centres. ADVERTISEMENT Learn more 'We have found significant reductions in both the frequency and duration of these practices, particularly since our new regulations and our improved, near real-time reporting system came into effect,' MHC director of regulation Gary Kiernan said. 'Furthermore, the steps we have taken in conjunction with approved centres to achieve these reductions includes mandatory training, new policies, and detailed post-incident reviews, emphasising a shift towards trauma-informed and person-centred care. 'We have also introduced enhanced oversight and reporting, requiring services to report each episode of seclusion or restraint within three working days of its commencement.' Rules around the use of seclusion and mechanical restraint were revised by the MHC in 2023, in an effort to prioritise the dignity and wellbeing of service users. The review was prompted by development in international human rights, advancements in person-centred care and evidence showing the 'harmful physical and psychological consequences of restrictive practices'. 'Our vision extends beyond the current scope of restrictive practices. It is our hope that this human rights approach will be applied more broadly to include all areas of care,' Prof Lucey added. 'It is our long-term goal of fostering a culture that prioritises dignity, autonomy and wellbeing across all aspects of mental healthcare, not just in the context of restrictive interventions.'
RTÉ News
31-07-2025
- Health
- RTÉ News
Decline in use of restrictive practices at mental health centres
There has been a significant decline in the use of restrictive practices - such as seclusion and physical restraint - across Irish mental health services in the past seven years. A report by the Inspector of Mental Health Services shows that the number of restrictive episodes in approved mental health centres fell by 62% from 2018 to 2024. There has also been a 91% reduction in seclusion and physical restraint in Child and Adolescent Mental Health Services (CAMHS) over the same period. In January 2023, the Mental Health Commission banned the use of mechanical restraint on children. There was an 80% decrease in seclusion episodes and a 57% decrease in physical restraint episodes in CAMHS approved centres between 2023 and 2024. In the report, Professor Jim Lucey said children were "specifically protected" from restrictive practices in Irish mental health care through a human rights-based approach." Overall, the rate of decline in seclusion episodes in 2023 and 2024 was almost twice that seen in the preceding four years. Similarly, the rate of reduction in the number of people physically restrained between 2023 and 2024 was twice that seen in the preceding four years. The majority of episodes of physical restraint in 2023 (97.4%) and 2024 (97.9%) were ten minutes or less. Over three quarters lasted five minutes or less. Two approved centres reported use of mechanical restraint in 2023, and one in 2024. Revised rules introduced a maximum duration of four hours for an order of mechanical restraint for immediate risk. All episodes in 2023 and 2024 were described as being used for "transfer purposes to and from court/hospital" where there was an immediate threat of serious harm.
The Journal
27-06-2025
- Health
- The Journal
Mental Health Commission finds 'concerning' attitude towards rules in HSE inpatient centres
THE MENTAL HEALTH Commission (MHC) has said that it has identified 'concerning attitudes towards compliance' in a number of HSE-run mental health centres which are persistently out of step with the rules of safe care. It comes against the backdrop of the standards of compliances improving overall in centres across the country that offer mental health services. The MHC has also said in its annual report for 2024 that there has been a 'sustained decline' in the use of restrictive practices in centres. Just six centres nationwide achieved 100% compliance with the regulations. 31 Enforcement actions had to be taken over incidents, events and serious concerns that arose in 20 centres which failed to meet regulations in response to the inspector's report. The findings found the worst failings in a small number of HSE operated facilities. Inspector of Mental Health Services Jim Lucey said that these enforcement actions show that the MHC has strengthened its commitment to 'regulatory vigilance' but that they also highlight issues that need to be addressed by HSE leadership. 'Closer attention by the HSE to underperforming approved centres would transform the national picture,' he said. Individual care planning, staffing levels, and the state of mental health facility buildings were identified as areas where the most centres were failing to meet the regulations. Advertisement A HSE spokesperson said that it welcomes the MHC report, and acknowledged that a number of HSE centres have 'recurring or increasing levels of non-compliance' that are 'disproportionately' impacting the health service's 'overall rating'. They added that the HSE will continue to invest in mental health services. There were also positive findings noted in the MHC report, including a reduction in the admission of children to adult mental health centres. Just five of these admissions occurred in 2024, which is the lowest annual number recorded to date. Lucey praised the decline in the use of coercive and restrictive practices and said that the finding indicates 'one of the most notable human rights advances in mental health care in Ireland in recent times'. Restrictive and coercive practices refers to patients being physically restricted and secluded for challenging behaviour, which mental health professionals are now trying to avoid in favour of other methods. The report notes similar levels of compliance with the rules across approved centres to 2023, but it notes that 'there was a marked difference in levels of compliance achieved across the HSE's Community Healthcare Organisations. 'Overall average compliance across all adult centres within a HSE CHO was just under 81% in 2024,' it states. CHO 6 (Wicklow, Dun Laoghaire, Dublin South East) had the worst average rate of compliance at 64.65%. Eight of the non-compliances found in the Acute Mental Health Unit in Cork University Hospital were deemed to be of a critical risk level, compared with six of the non -compliances in the centre in Tallaght Hospital, and four in the Midland Regional Hospital in Portlaoise. Readers like you are keeping these stories free for everyone... A mix of advertising and supporting contributions helps keep paywalls away from valuable information like this article. Over 5,000 readers like you have already stepped up and support us with a monthly payment or a once-off donation. Learn More Support The Journal
RTÉ News
27-06-2025
- Health
- RTÉ News
31 enforcement actions issued to safeguard mental health patients
Thirty-one enforcement actions were issued last year to safeguard mental health patients and residents in 20 centres nationwide. The Mental Health Commission's Annual Report for 2024 highlighted deficiencies in some Health Service Executive facilities that inspectors say must be addressed by the executive's leadership. ''Closer attention by the HSE to underperforming approved centres would transform the national picture," said Mental Health Commission CEO John Farrelly. In 2024, overall compliance across HSE-funded adult centres was just under 81%, while independently run adult centres achieved 88.5% compliance. There was an increase in the number of high and critical non-compliances in 2024 compared to previous years. 366 non-compliances were recorded in total with critical non-compliances concentrated in a few HSE-approved centres. Six facilities achieved 100% compliance including Aidan's Residential Healthcare Unit; Ashlin Centre; Carraig Mor Centre; Grangemore Ward, St Otteran's Hospital; and St Patrick's University Hospital. Those achieving 70% overall compliance or below with regulations include Acute Psychiatric Unit, Tallaght University Hospital (70%); Units 2, 3, 4 and Unit 8 (Floor 2), St Stephen's Hospital, Cork (66.67%); Department of Psychiatry Letterkenny University Hospital (63.33%); Elm Mount Unit, St Vincent's University Hospital (62.07%); Acute Mental Health Unit, Cork University Hospital (60%); and the Central Mental Hospital, Portrane (56.67%). Examples of non-compliances may include lapses in individualised care planning, risk management, staffing, and premises. The HSE welcomed the publication of the Mental Health Commission (MHC) Annual Report. It acknowledged that, in some areas, compliance with regulations for premises, staffing, risk management and care planning remain areas of concern. As part of Sláintecare, the HSE said that a new regional structure will improve how services are run in each area and provide a consistent quality of care across the country. The HSE budget for mental health for 2025 is €1.458bn, 5.4% of the overall HSE budget this year. Restrictive practices are also declining in favour of a more rights-based approach for mental health patients and residents. "The decline in the use of coercive and restrictive practices represents one of the most notable human rights advances in mental health care in Ireland in recent times," said Inspector Professor Jim Lucey. "These advances demonstrate how regulation can drive important human rights improvements and result in key behavioural change in the way services are delivered." The Mental Health Commission is an independent statutory body that aims to foster and promote high standards of care and good practice in the delivery of mental health services. It also ensures that the interests of those involuntarily admitted are protected under the Mental Health Act 2001.
Irish Times
27-06-2025
- Health
- Irish Times
‘Critical' breaches of regulations at number of HSE-run mental health centres
Patients at a number of HSE -run mental health centres are receiving substandard care due to 'persistent, critical' noncompliance with regulations, requiring 'urgent redress', the sector's watchdog has found. On Friday, the Mental Health Commission published its 2024 annual report, which pointed to a number of positive improvements in recent years. According to the report, six centres – four of which were HSE-run- were 100 per cent compliant with regulations, and there was a reduction in the use of restrictive practices. However, Prof Jim Lucey, inspector of mental health services, said the number of breaches of minimum standards and critical non-compliances has increased, and 'the bulk of these is concentrated in a small number of HSE-led services'. READ MORE The National Forensic Mental Health Service (NFMHS) had 17 breaches with regulations, while Elm Mount in Dublin, Tallaght University Hospital, St Stephen's Hospital in Cork and the Department of Psychiatry in Letterkenny were also highlighted for non-compliances. In terms of 'critical' non-compliances, Cork University Hospital had the highest with eight, followed by Tallaght University Hospital in Dublin, which had six, and Portlaoise Hospital, which had four non-compliances rated critical. The Department of Psychiatry in Letterkenny and the independent sector provider St John of God Hospital in Stillorgan, Co Dublin each had three non-compliances rated as critical. 'Persistent findings of critical noncompliance indicate a high likelihood of risk. Their increasing volume in a small number of approved centres is a substantial concern,' the report states. According to Prof Lucey, regulations around therapeutic services, general health, risk management procedures and privacy are 'matters of human rights and dignity'. 'The fact that these humanistic care standards are breached so persistently in some HSE-approved centres and at this level is a matter of great concern to the inspector,' he said, stating these breaches are 'matters in need of urgent redress'. 'Substandard levels of staffing, and persistent neglect of approved centre premises, are not matters to be minimised. I find it increasingly necessary to ask this question: why do some HSE centres persistently operate with poor levels of compliance?' The commission has written to the HSE seeking intervention in centres that are found to be persistently noncompliant. Overall, the report highlights significant progress in the standard of care provided in mental health centres in Ireland. According to the report, there was a 18.6 per cent decrease in the number of reported episodes of physical restraint compared with 2023. There were also seven instances of centres being over capacity, a significant reduction on the 46 instances in 2023. The commission took 31 enforcement actions against 20 registered premises last year to 'safeguard service users and drive immediate improvements'. Minister for Mental Health Mary Butler welcomed the publication of the report, adding: 'it is also encouraging to see that in 2024, the number of children admitted to adult units fell to its lowest level on record and we saw a further decrease in episodes of seclusion and restraint'. In a statement, the HSE acknowledged in some areas compliance with premises, staffing, risk management and care planning 'remain areas of concern'. 'A small number of HSE-approved centres have recurring or increasing levels of noncompliance that disproportionately impacts the HSE's overall compliance rating,' the statement said.
