Patient was locked alone in room for 101 days, Mental Health watchdog finds

A patient locked alone in a room for 101 days is just one of 1,840 episodes of 'seclusion' highlighted by the Mental Health Commission (MHC) in its 2020 annual report.  Stock picture.

A patient locked alone in a room for 101 days is just one of 1,840 episodes of 'seclusion' highlighted by the Mental Health Commission (MHC) in its 2020 annual report. 

The commission found that 643 residents across 28 different mental health centres were secluded last year. 

In addition to seclusion, the report also found “serious and persistent weaknesses” in the country's mental health services, which were aggravated by the Covid-19 pandemic.

The use of mechanical restraints — soft arm and leg cuffs, mittens, and straps — was reported by two centres.

In one centre, a “young person” was restrained 150 times, including one session which lasted 953 hours and 20 minutes, or 39 days.

The report says: “This was to prevent staff from being harmed and to reduce frequent episodes of seclusion and physical restraint that the young person had undergone.” 

On foot of concerns from the MHC, a review was carried out by the Child and Adolescent Forensic Mental Health Services.

The Mental Health Commission report also found that of the 1,919 admission orders for involuntary detention, almost one third were initiated by An Garda Síochána.

MHC chief executive John Farrelly said these statistics were "extremely concerning".  

He said applications from the HSE’s authorised officers have made up the lowest number of applications every year since 2007, but welcomed the 5% drop in family applications.

Mr Farrelly said: “The pandemic has caused profound suffering and stress amongst residents, staff, and services.

It is clear that the impact of the virus in 2020 laid bare in stark terms where our mental health system requires urgent attention, investment, revision, and reform.

The report also shows 27 young people admitted to adult wards, down from 54 in 2019. 

Children were admitted to an adult ward 10 times in University Hospital Kerry, six times in University Hospital Waterford, and once each at Cork University Hospital, Mercy University Hospital, and Ennis Hospitals.

There were 98 beds at the end of 2020 for Child and Adolescent Mental Health Services; 62 in Dublin, 20 in Galway, and 16 in Cork.

These received 459 admissions with an average stay of 40 days.

Overall, however the MHC found 89% compliance with national regulations compared to 78% in 2019, and 42 centres had 90% compliance or higher.

Mr Farrelly praised staff for supporting residents in difficult circumstances, despite the report finding almost one in three centres were short-staffed. 

He said: “We compliment services for their resilient, collaborative, flexible, and committed efforts, and for working so hard during the year to protect residents and, ultimately, save lives.” 

The report also contains the report of the Inspector of Mental Health Services, Dr Susan Finnerty.

She found low compliance with individual care plans, at just 59%.

“There is a failure by services to ensure that people with a mental illness have an individual care plan that enables recovery and involves the person in caring for their own mental health,” she said.

“In short, there is a lack of leadership, training, and attitude in this area and this must change without delay.”