Money buys better mental health treatment, commission warns

University Hospital Waterford: The Mental Health Commission has warned that financial status is having an increasing impact on the level of mental health treatment patients can access. Picture: Denis Minihane

The Mental Health Commission has warned that financial status is having an increasing impact on the level of mental health treatment patients can access.

The commission’s annual report, published today, found services run by independent or voluntary service providers tend to have higher overall compliance with standards than all but one of the HSE’s nine regions.

They identified many “outdated, unsuitable buildings which have suffered years of environmental neglect” in public services despite investment in several new approved centres recently.

The exception is across the Mid-west region in Munster where public centres were found to have a 97% average compliance rate.

Chief executive John Farrelly called for a “targeted, funded strategic capital investment programme” in public mental health.

This is needed he said: “to ensure every person in Ireland has equal access to a consistent quality of care.” He warned the report found the difference in standards increased during the pandemic.

“A top-level view of our work in 2021 shows a gap emerging between independent providers and the HSE particularly in relation to premises and individualised care planning,” he said.

“While we recognise the investment in premises to date, the current approach to structural improvements in a significant number of HSE centres is inadequate.” 

The report also highlights pressures on the Child and Adolescent Mental Health Services (CAMHS) including the shortage of in-patient beds in the six specialist units.

It found 32 admissions involving 27 children to 11 adult units although this was down on the 54 admissions during 2019. Of these admissions 31% or almost one in three took place because there was no room in the CAMHS units.

Last year there were 472 admissions to children’s units including 47 involuntary admissions.

While some children stayed just a day, the average was 41 days and at least one child was admitted for 261 days.

Overall, the report states there were 2,549 involuntary admissions, with 35% of these made by gardai.

The report notes the commission continues to be “very concerned” about the rising number of such applications made by gardaí.

Bed shortages in adult units were also highlighted with 64 instances of over-capacity reported by five centres, including Acute Psychiatric Unit 5B, University Hospital Limerick and the Central Mental Hospital. 

Ten children were admitted to the adult unit in the Department of Psychiatry, University Hospital Waterford last year

At least one child of 13 was physically restrained during treatment, with the oldest person subject to restraint aged 93 years during 2021.

The commission however, identified a decrease in the number of times patients were physically restrained to 3,460 episodes involving just over 1,000 patients down from 3,990 episodes the year before.