Central Mental Hospital rehab unit will begin taking in patients this year

The 30-bed ICRU at the Central Mental Hospital in Portrane was part of the 2020 Sharing The Vision strategy, which also envisaged regional units. File picture: Colin Keegan

The long-awaited unit for people with complex psychiatric illnesses and associated violent behaviour will begin taking in cases by the end of the year, the Government has said.

The Intensive Care Rehabilitation Unit (ICRU), located at the Central Mental Hospital, in Portrane, North Dublin, was supposed to start opening in 2023.

A 30-bed facility, the ICRU formed part of the 2020 Sharing The Vision strategy, which also envisaged regional units.

It is thought it could take over a year to complete the phased opening of all beds at the ICRU.

The development comes as the Minister for Mental Health Mary Butler is due to announce that 130 beds are now operational at the hospital, which is the full capacity of the main facility.

The number had been stuck at around 110 for years, including as recently as last February. It is understood the recruitment of staff has brought the operational capacity to 130.

The facility had a waiting list of around 40 people last February, dropping to just under 30 currently.

Total capacity of 170

The total capacity of the Central Mental Hospital campus, as announced before the facility moved from Dundrum to Portrane in 2022, is 170, comprised of: 

• The 130-bed main Central Mental Hospital; 
• The 30-bed ICRU;
• A 10-bed Forensic Camhs unit.

The Department of Health said the phased opening of the ICRU is “due to commence” by the end of 2026.

The purpose of the unit is to provide secure care for a small number of people with “complex mental health needs” on a long-term basis.

It should increase the capacity of the overall National Forensic Mental Health Service, including taking in inmates with serious mental health disorders from prisons.

Prison service highlighted need for unit

The Irish Prison Service has long highlighted the need for more spaces in the Central Mental Hospital to take inmates with severe psychiatric illnesses.

Once the ICRU opens, it is expected to be early 2028 before all 30 beds are operational. This will be followed by a review, which will inform further regional units in the country.

The NFMHS now has 580 staff, with 530 attached to the Central Mental Hospital (CMH) campus and up to 50 at the in-reach service in prisons and Oberstown Children Detection Centre.

Meanwhile, Ms Butler has asked clinicians at the NFMHS to review its “model of care”, to see if it needs any changes, given indications of emerging trends.

This includes cases requiring, what sources said, is a “high level of support”, even higher than what is typically provided at the CMH, reflecting greater complexity of needs and unpredictability of behaviour.

The CMH has had to place a person with acquired brain injury in one of the units — a 10-bed section with large common areas — such is the level of support required and risks of injury to staff.

This has meant that, since the start of the year, 10 people were moved out of that unit to the vacant Camhs unit.

It is understood there is a plan to now move this individual to a smaller unit, possibly a six-person one, and bring the 10 people back to their original unit.

It is not yet clear what the plan is for the Camhs unit, with an apparent drop in the need for forensic services. This is another reason why clinicians have been asked to conduct a review.

In the meantime, the Camhs unit will be used to assess incoming cases, including from prisons.

• Cormac O’Keeffe, Security Correspondent