'Serious concerns' after 17 areas of non-compliance found at Central Mental Hospital
The Central Mental Hospital is the country’s only secure forensic institution and provides therapeutic detention to those found not guilty by reason of insanity and other categories of offenders. File picture: Colin Keegan, Collins Dublin
The chief mental health inspector has said the regulatory and legal breaches at the country’s state-of-the-art forensic mental hospital – opened just over two years ago – raise “serious concerns” about the operation of the facility.
The Central Mental Hospital in Portrane, north Dublin – with a construction cost of €200 million – is the country’s only secure forensic institution and provides therapeutic detention to those found not guilty by reason of insanity and other categories of offenders.
The move of the CMH from Dundrum was delayed by over two years before it opened officially in November 2022.
Forensic bed capacity was supposed to increase from around 100 in Dundrum to 170 at Portrane. When it opened it had 110 beds.
According the Mental Health Commission CMH Inspection Report 2024, the centre is registered to cater for 130 people with a capacity for 114 people and 110 residents during inspection.
The report said the CMH had a compliance rate, in relation to laws and regulations, of just 51% in 2024, down from 69% in 2023 and 82% in 2022.
The Inspector of Mental Health Services, Professor James Lucey, said: “The 2024 inspection report highlighted an unprecedented 17 areas of non-compliance for the centre, a concerning upward trajectory of non-compliance from the previous year, of 11.”
He said 10 of 17 areas were reoccurring, and five regulatory areas were deemed a higher risk than the previous year, one of which was rated “critical”, on the use of seclusion.
Prof. Lucey said:
He said that following the unannounced inspection, during May 28-31, 2024, the MHC issued an “immediate action” to the CMH management, which provided “assurances and undertakings”. This included actions on monitoring of seclusion rooms, improvements to risk management and review of individual care plans.
Prof. Lucey said “evidence” was provided to the MHC of these improvements.
The CMH has a high secure unit for 40 men, a medium secure unit for 30 men and a unit for 18 women. There is a separate unit for 10 men with intellectual and developmental disabilities and a further 18-bed unit for males in recovery or pre-release.
A planned forensic child forensic unit, with 10 beds, has not yet opened.
It said there were “staffing shortages” across the centre, including nursing, occupational therapy, psychology and social work, pointing out that with the HSE embargo, the centre was unable to recruit for vacant posts. It said psychology had waiting times from two weeks to six months.
The report said feedback from residents and families was that the new CMH was “more restrictive” than Dundrum, with some family members reporting difficulties accessing the site on public transport for visiting times.
It said “staff were described as brilliant and being approachable mostly”, with people commending activities, such as the gym, music and gardening.
The inspection team found the centre was “not ventilated throughout and had offensive odours” and that the bathrooms, with rooms with a physical bath, were “extremely malodorous”.
