'Urgent investment' in mental health centres needed

Chief executive of the Mental Health Commission John Farrelly. There were 422 cases of Covid-19 in mental health facilities between March and July last year. Picture Jason Clarke

Urgent investment in mental health facilities is needed as a review found that "outdated buildings"  constrained efforts to curtail Covid-19 outbreaks.

A review of care during the pandemic by the Mental Health Commission found 442 cases of the virus between March and July last year.

The review, published on Thursday, states: “Staff in the residential services, which were monitored by the MHC, were at higher risk of contracting the disease than residents.” 

They found 36% of the cases were among residents, and 64% were staff from different areas. Among staff, nurses were the most badly affected, making up 55% of the cases.

Analysis showed people who are resident in acute settings and long-term care can be susceptible to Covid-19 for a variety of reasons.

The review found: “These include the fact that many services are still located in multi-occupancy, outdated buildings, and individuals receiving care and treatment for mental health issues may be less able to readily comply with infection, prevention, and control guidelines.” 

And while it highlights “the high levels of knowledge and expertise demonstrated by staff regarding infection, prevention and control practices”, the review found staff are constrained by the physical settings.

Call for 'urgent investment'

The MHC is now calling for “urgent investment” and “more robust legislation” to make infrastructural changes at the sites.

“The purpose of our paper is to first and foremost share learnings and developments to reflect the quality of work undertaken in mental health services during the pandemic,” said the chief executive of the Mental Health Commission, John Farrelly.

“It is also critical we do so to ensure that services are as well prepared as possible for any further surges of Covid-19 or, indeed, future pandemics.

The MHC works with 184 mental health services, which care for about 3,900 services users around Ireland.

Among the recommendations are that guidance to staff is more tailored to residential mental health services.

They recommend national guidance be relevant to all service types and to ensure parity between mental health and physical health services.

Other recommendations include retention of MHC-implemented collaboration, reporting and escalation protocols with the HSE and the Department of Health and that training in infection prevention and control best practice continue to be prioritised.

Vaccination programmes

The MHC is also calling for mental health services to be considered parallel to physical health services for vaccination programmes.

Director of regulation Gary Kieran said: “In compiling the paper, we learned of numerous examples of how staff in mental health services worked extremely hard to support and protect residents who have been impacted by the pandemic. The MHC wishes to acknowledge the sacrifices and tireless work of frontline staff in protecting residents.” 

The MHC also found examples of innovation inspired by the challenges of cocooning, including around the use of technology for information sharing and caring for residents.

During the pandemic, the MHC worked with the HSE to create a fast-track registration scheme, giving centres hit by Covid-19 outbreaks or at high-risk immediate access to new and more suitable buildings.