'Significant change' for better in mental health services

Reports of physical restraint dropped by 11.5% compared to 2024. 

Mental health services have seen a “significant change” for the better, but the construction of modern premises for public patients must be faster.

That is according to the Mental Health Commission annual report, which highlights “repeated areas of non-compliance” with regulations for premises, staffing, individual care plans and risk management procedures.

Out of 67 centres, eight achieved full 100% compliance with all regulations. Some 24 regulations had a compliance rate of 80% or over.

Reports of physical restraint dropped by 11.5% compared to 2024. 

Some 454 residents were secluded in a room compared to 434 the year before, but the commission noted this remains lower than previous years.

Applications by An Garda Síochána to involuntarily detain people increased last year compared to a small number of applications made by authorised officers, however.

Chief executive John Farrelley said infrastructure is a key gap, saying: “It comes down to the HSE mechanisms for delivering capital programmes and it needs to be quicker.” 

He described waiting on new premises for years as “not fair on the people who live in those areas".

About 70% of all centres are public, with many private centres housed in new buildings.

“That means if a person has health insurance, they have better choices,” he said. 

“And the person who doesn’t have health insurance doesn’t have the same choices, but the standards should be the same.” 

He pointed to the “dramatic difference” following an investment of €6.4m by HSE Dublin & Southeast for a new community residence in Dungarvan as an example of what can be done.

However, he said at the Mercy University Hospital, “staff there deserve a medal for being able to get the compliance levels within that physical building". 

It’s "just not designed for mental health", he said.

In general, he said: “Seclusions are down, physical restraint is down, the amount of conditions we’re having to apply to centres is down.

“Notwithstanding that [some issues remain], if we could get the last three or four regulations right, we’re seeing a significant change in the system.” 

This is reassuring, he said, adding: “I’m definitely noticing a shift when I go out speaking to people and meeting the staff.” 

Responding to the report, the national coalition of 83 organisations, Mental Health Reform, called for “continued investment”.

Chief executive Helen Gillespie Brown said: “While there have been some positive improvements, the report raises significant concerns regarding high levels of non-compliance in key areas.” 

She also welcomed the decline in use of restrictive practices as showing “an important cultural shift towards human-rights-based care”.