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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.
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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.
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