‘Smelly and drab psychiatric wards beyond belief’

Wards in a psychiatric hospital earmarked for closure were “drab, bare, institutionalised and smelly”.

Furthermore, mould was visible in some areas along with a smell of urine, an inspection report by the state’s mental health watchdog has found.

The Mental Health Commission has long called for the closure of St Finan’s in Killarney but it remains open, although plans are afoot to accommodate patients elsewhere.

The commission, which inspected the hospital last September, said it was “beyond belief” service users were treated in such conditions with some detained against their will, the report noted.

“Paint was peeling, plaster had fallen off the walls, there was mould in some areas, and the smell of urine in St Peter’s ward was strong. It was a credit to the cleaning staff that they were able to keep it clean,” it said.

“The food was institutionalised with no choice and no menu for the residents; drinking water was available only on request and institutionalised terminology such as ‘ground parole’, ‘absconsion risk’ and ‘ward duties’ were prevalent and communal underclothing were still in use.”

Female residents, it emerged, were sleeping in tiny cell-like rooms with an uncovered window in the door and a convex mirror in the room, which meant that passers-by could see every part of the bedrooms and the residents at any time of the day or night, the report found. The service was requested by the commission to immediately remedy this situation.

Inspectors were “greatly concerned” that people, who were acutely unwell, continued to be transferred to totally unsuitable care in St Finan’s Hospital.

“Of even more concern is that there were direct admissions to the hospital.”

Meanwhile, the commission reported that residents of a long-stay forensic mental health unit in Cork City have no access to a clinical psychologist and care plans were of a “very minimal standard”.

At the time of inspection last September, Carraig Mór, a unit which has long been criticised for lack of rehabilitation, had no structured psychological therapies and rehabilitation for people living in its intensive care unit.

The report found that care was limited in scope to largely medical and nursing domains.

Inspectors called for a clinical psychologist to be immediately appointed to its forensic rehabilitation team.

The report also questioned the practice of two members of staff doing an eight-hour round trip of 572km to bring a ‘resident’ to Carraig Mór once a month for the purpose of administering and home again.

“This seems a very unsatisfactory use of scarce resources and did not appear to facilitate recovery and reintegration in the community,” it said.

€6m psych unit nears

* A new 40-bed unit for psychiatric patients in Co Kerry will pave the way for the long-planned closure of St Finan’s Hospital in Killarney.

The HSE has confirmed funding for a €6m residential facility, to be built on the site of the Cherryfield High Support Hostel, formerly the Killarney Isolation Hospital, which is to be demolished.

Construction is due to start this year and be completed next year.

The unit will enable the closure of the Victorian-era St Finan’s as it will cater for the remaining residents — just over 40 — in the hospital, along with others who require long-term residential care.

Funding of €2m has also been approved for the construction of a four-bed, high-observation unit at the psychiatric department in Kerry General Hospital, Tralee.

The Psychiatric Nurses Association (PNA) welcomed both developments, but said it could be 2014 before work on the 40-bed unit was finished, as no design or planning work had been done.

Cormac Williams of the PNA said it was imperative there be no further ward closures in St Finan’s until the new unit was ready to receive patients.

The Mental Health Commission is reviewing the future of the hospital’s St Peter’s ward, due to close by the end of next month.

The PNA has asked the HSE South and the commission to postpone the closure until new facilities were provided.

The HSE area manager in Kerry, Michael Fitzgerald, said the new facilities would provide an “appropriate therapeutic environment for patients and would assist in the ongoing development of community-based mental health services”.

“The existing residential units in St Finan’s Hospital and the O’Connor unit are no longer fit for purpose and we look forward to progressing the two new facilities which will allow residents to move to purpose-built, modern and more appropriate facilities,” said Mr Fitzgerald.

St Finan’s, which dates to 1849, had more than 1,000 patients at its peak in the mid-20th century.

Over the years, conditions in the hospital have been criticised as being unacceptable and unsuitable by the Inspector of Mental Hospitals.

— Donal Hickey

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