Consent to treatment among ‘critical risks’ at mental health facilities

Residents not being able to access their bedrooms until 10pm and concerns in relation to consent to treatment are just some of the issues raised about a number of mental health facilities.

The Mental Health Commission (MHC) published five inspection reports which highlighted two centres — St Catherine’s Ward at St Finbarr’s Hospital in Cork and Bloomfield Hospital in Dublin — which had failings deemed to be “critical risks”.

At the HSE-run St Catherine’s Ward at St Finbarr’s Hospital in Cork, inspectors noted that while there had been a “modest improvement” in the level of compliance at the 21-bed unit in the last three years, the risk ratings applied to areas of non-compliance had deteriorated.

Following this inspection, risk management was deemed a critical risk,” said the report. “In 2018, 75% of noncompliances were considered high or critical risk. No compliances were rated as excellent.

The report found that consent to treatment processes were “inadequate and require immediate review to ensure compliance” and there were “multiple deficits” in the processes relating to the code of practice on admission, transfer, and discharge.

Due to limited staff availability and the structure of the unit, residents did not have access to their bedrooms until 10pm. This was considered a restrictive practice “not supporting or respecting the autonomy of the person”.

Bloomfield Hospital in south Dublin was also highlighted as having an area of “critical risk”. The 114-bed voluntary hospital provides care for patients with severe and enduring mental illness, dementia, and provides a national facility for the care of patients with severe neuropsychiatric conditions, in particular Huntington’s disease.

While the inspection found a number of areas of excellent care, there was no overall improvement in compliance relative to 2017.

The MHC inspectors said it was “a matter of concern” that there has been repeated failure by some facilities to meet the legislative requirements regarding consent to treatment and this matter was therefore been rated a critical risk.