Mental health facilities ‘seriously deficient’

Mental Health Reform says it is “deeply concerned” that some vulnerable people still live in “mini-institutions” where there is no respect for their privacy or dignity.

The national coalition that promotes improved mental health services was responding to inspection reports published by the Mental Health Commission.

The commission found “serious deficiencies” in many of the 43 nurse-supervised residences it inspected last year.

Director of Mental Health Reform, Shari McDaid, said an expert group recommended that HSE-operated community residences should be regulated three years ago.

“It has been flagged as far back as 2003 by the Inspector of Mental Health Services that some of these types of residences are operating as ‘mini-institutions’,” said Ms McDaid.

The Government must legislate to extend the remit of the commission so it can create standards and close down residences that fall below standard, she said.

In 14% of the residences inspected doors were locked and the people who lived there were not free to leave.

In more than three-quarters (77%) of the residences, those living there could not lock their bedroom doors.

The residences were developed for people who had been living in large psychiatric institutions but nowadays also accommodate those discharged from both long-stay and acute mental healthcare services.

Commission chairman John Saunders said there is a “serious” lack of suitable accommodation options and staff to help people progress towards the goal of independent community-based living.

Mr Saunders said the goal should be to help people graduate to more independent settings as they gain skills and confidence.

However, only half (51%) of the 43 residences inspected had a rehabilitation team. The commission found that only 44% of residences were in good physical condition. One in five (19%) needed urgent maintenance and refurbishment.

Just six out of ten (59%) of residences offered single rooms. Two residences had bedrooms that catered for four people.

In residences with shared rooms, 58% had no privacy between beds or within the bedrooms.

In one nine-bed residence, inspectors found that those living there did not have free access to the kitchen.

There was a large back garden but it was overgrown and in need of attention. An outside toilet was dirty and smelly.

An eight-bed residence for adults with intellectual disabilities had single bedrooms but they were sparsely decorated and lacked personal touches.

There was no review or oversight of restrictive practices, which were many.

A large purpose-built community residence with 18 beds had 17 residents when the inspectors called.

Staff said the front door was kept locked because a number of residents were at risk of leaving the 30-year-old building and wandering.

Residents did not have access to the kitchen to prepare meals or snacks for themselves.

They did not have a key to their own bedrooms but could ask staff to lock them. One bedroom had a glass panel in the external door with no screening.

The internal garden area was being redeveloped when the inspectors called.

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