HSE criticised for admitting 21 children to adult acute psychiatric unit

The HSE has been criticised for admitting 21 children to an adult acute psychiatric unit where more than half the staff did not have up-to-date training in Children First, the national guidance for safeguarding children.

The high volume of child admissions to the unit at the Midlands Regional Hospital in Portlaoise occurred between June 2014 and December 2015, contrary to the code of practice relating to the admission of children under mental health legislation.

A report published last month by the Mental Health Commission found that nine children had been admitted to the Department of Psychiatry at St Luke’s Hospital between March 2014 and November 2015.

The most recent commission inspection in relation to Portlaoise found that 18 of 35 staff who potentially had care of the children had not received up-to-date training in Children First.

In response, the HSE said it would “seek training for staff who have not received training in Children First policy”.

The HSE also said children “are only admitted on an emergency basis and we seek appropriate facilities in suitable centres as soon as possible”.

The commission was also critical of some aspects of the use of electro convulsive therapy (ECT), sometimes called “shock therapy”.

Inspectors found that there was “no record of separate cognitive assessment being undertaken prior to each administration of ECT” and that in the case of one patient, there was no signed consent for anaesthesia.

In response, the HSE said there would be an audit of ECT compliance every three months.

There was additional criticism from the commission in relation to “a number of errors and uncertainties in the prescription and administration of medication” and failure to address risks highlighted in a 2014 ligature audit.

Yesterday, the commission said the unit’s shortcomings had been highlighted to the HSE national directorate on a “number of occasions” and that it is expecting a lengthy report this week.

The commission said that if the report is inadequate, it would “escalate its enforcement further”, including prosecution or removing the unit from the register of approved centres.