Central Mental Hospital signs first conditional discharge

THE first ever order for a conditional discharge from the Central Mental Hospital (CMH) has been signed under new legislation which allows for the recall of patients if strict rules are breached.

The new law is an amendment to the Criminal Law Insanity Act 2006 and provides the Mental Health Review Board, which makes decisions on freeing patients referred by the courts, with the crucial option to discharge them with conditions attached.

Since the board was set up in 2006, it has only ordered two discharges:

* An unconditional discharge in July 2010.

* A conditional discharge in March 2011.

Before the law was amended the board could only release people unconditionally, which in some cases it did not consider safe. This meant people who may have been suitable for release were not let out as there were no safeguards in place.

According to Freedom of Information documents released to the Irish Examiner the person unconditionally discharged last year had been detained for more than 20 years.

Ten people detained at the hospital have been there for more than 20 years. One has been there since 1965, three since the 1970s and six since the 1980s. Most are classified as “not guilty by reason of insanity”.

A Mental Health Review Board spokesman said it is important to point out that someone discharged unconditionally is completely free.

“With a discharge that is subject to conditions they can be quite onerous. They will be set down in the individual order and tailored to the circumstances of the person and monitored by the hospital. If a person breaches those conditions they will be brought back.”

The spokesman said every patient who had been ordered to the CMH by the courts was subject to a review every six months.

However, he said many of the patients were extremely disturbed during initial reviews and it is only over a long period that improvements can be seen.

The board’s latest annual report from 2009 shows that 167 reviews were carried out, with 44 recorded at the patient’s sixth review.

There are more than 100 patients at the CMH. Just under half were found not guilty by reason of insanity by a court.

Six patients are listed as unfit to plead, two are wards of court, while others have been transferred from other psychiatric facilities.

According to the latest inspection report, the Health Service Executive recruitment embargo continues to “pose a serious and considerable strain” on the service. When this warning was made there were 188 nurses. Now there are 158.


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