Patients at a number of HSE-run mental health centres are receiving substandard care due to “persistent, critical” noncompliance with regulations, requiring “urgent redress”, the sector’s watchdog has found.
On Friday, the Mental Health Commission published its 2024 annual report, which pointed to a number of positive improvements in recent years.
According to the report, six centres – four of which were HSE-run – were 100 per cent compliant with regulations, and there was a reduction in the use of restrictive practices.
However, Prof Jim Lucey, inspector of mental health services, said the number of breaches of minimum standards and critical non-compliances has increased, and “the bulk of these is concentrated in a small number of HSE-led services”.
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The National Forensic Mental Health Service (NFMHS) had 17 breaches with regulations, while Elm Mount in Dublin, Tallaght University Hospital, St Stephen’s Hospital in Cork and the Department of Psychiatry in Letterkenny were also highlighted for non-compliances.
In terms of “critical” non-compliances, Cork University Hospital had the highest with eight, followed by Tallaght University Hospital in Dublin, which had six, and Portlaoise Hospital, which had four non-compliances rated critical.
The Department of Psychiatry in Letterkenny and the independent sector provider St John of God Hospital in Stillorgan, Co Dublin, each had three non-compliances rated as critical.
“Persistent findings of critical noncompliance indicate a high likelihood of risk. Their increasing volume in a small number of approved centres is a substantial concern,” the report states.
According to Prof Lucey, regulations around therapeutic services, general health, risk management procedures and privacy are “matters of human rights and dignity”.
“The fact that these humanistic care standards are breached so persistently in some HSE-approved centres and at this level is a matter of great concern to the inspector,” he said, stating these breaches are “matters in need of urgent redress”.
“Substandard levels of staffing, and persistent neglect of approved centre premises, are not matters to be minimised. I find it increasingly necessary to ask this question: why do some HSE centres persistently operate with poor levels of compliance?”
The commission has written to the HSE seeking intervention in centres that are found to be persistently noncompliant.
Overall, the report highlights significant progress in the standard of care provided in mental health centres in Ireland.
According to the report, there was a 18.6 per cent decrease in the number of reported episodes of physical restraint compared with 2023. There were also seven instances of centres being over capacity, a significant reduction on the 46 instances in 2023.
The commission took 31 enforcement actions against 20 registered premises last year to “safeguard service users and drive immediate improvements”.
Minister for Mental Health Mary Butler welcomed the publication of the report, adding: “it is also encouraging to see that in 2024, the number of children admitted to adult units fell to its lowest level on record and we saw a further decrease in episodes of seclusion and restraint”.
In a statement, the HSE acknowledged in some areas compliance with premises, staffing, risk management and care planning “remain areas of concern”.
“A small number of HSE-approved centres have recurring or increasing levels of noncompliance that disproportionately impacts the HSE’s overall compliance rating,” the statement said.
