New human rights model for mental health treatment aims to reduce use of physical restraint
As reported in the Irish Examiner last month, Mental Health Commission report found an overall decrease in the use of physical restraint, but a significant increase in child in-patient psychiatric units. File photo
The Mental Health Commission (MHC) and the World Health Organization (WHO) have launched a new care model which they hope will “transform” how people with mental illness are treated.
The human rights-based approach covers everything from lack of access to proper services and coercive care, such as physical restraint. The launch coincides with the recent publication by the MHC, the State’s regulator of mental health services, on restrictive practices, which includes seclusion and physical restraint.
As reported in the last month, this report found an overall decrease in the use of physical restraint, but a significant increase in child in-patient psychiatric units.
The overall decrease — from 3,460 instances in 2021 to 2,945 (-15%) — across the country’s 67 approved centres was driven by a trend in adult in-patient psychiatric units. But there was a 47% jump in three of the four Child and Adolescent Mental Health Service (Camhs) units, from 248 in 2021 to 365 in 2022.
The MHC’s 2022 Restrictive Practices Activity Report did point out that use of restrictive practices can be “skewed” by frequent use in relation to a small number of residents arising from their clinical needs and risks to themselves and others.
The commission said that restrictive practices should only be used “in rare and exceptional cases” as an emergency measure.
Speaking at the launch, MHC chief executive John Farrelly said the commission has given a “strategic commitment” to a human-rights-based approach, aligned with Ireland’s commitment to the UN Convention for the Rights of Persons with Disabilities.
He said the commission already had the support of the HSE, National Ambulance Service, An Garda Síochána, Irish Prison Service and the Courts Service.
Michelle Funk, head of WHO’s Policy, Law and Human Rights Unit, told the launch that the decision by the MHC to reach out directly to first responders to ensure their involvement was something the WHO “have not seen before”.
She said it is a serious commitment, which “if implemented correctly” could vastly improve the lives of people with mental health difficulties.
MHC said recent research had shown that restrictive practices can “increase the risk of trauma and may trigger symptoms of previous experience of trauma” and, of themselves, can and do “lead to physical and psychological harm”.
Mr Farrelly said the commission published in September 2022 revised rules governing restrictive practices, which came into effect in January 2023.
Under this, relevant staff must undertake training on a range of areas, including trauma and human rights.
