SERIOUS LAPSES in standards of care for patients in large psychiatric hospitals have been identified by the independent watchdog for the mental health sector.
Despite repeated Government pledges to close many old psychiatric hospitals, the Inspector of Mental Health Services has found that many people continue to be admitted to long-stay wards.
The inspector’s 2008 report shows many residents have little or no therapeutic activity, multi-disciplinary input or care plans, which are required by mental health regulations. In addition, the inspectorate found many of these lapses in care at more modern facilities where few people had proper inputs from multidisciplinary teams.
Some facilities were praised for their high standards of care across a range of areas, in particular the department of psychiatry at St Luke’s Hospital in Kilkenny and private facilities such as St Patrick’s in Dublin.
At St Ita’s in Portrane, which provides care for up to 140 inpatients, it says “unacceptable” conditions in the hospital had been repeatedly highlighted with little evidence of change.
“It is disappointing to report again that the fabric of the building remained unchanged,” it says. “Piecemeal maintenance and decoration had little impact on the quality of the environment for residents. There were insufficient bathing facilities in the acute admissions wards and the furniture in Willowbrook was unacceptable. It is a source of frustration to the residents and clinical staff that no action had been taken to resolve the problems.”
In the meantime, the debate over the future location of inpatient acute beds in Beaumont Hospital continues, the report says, and any new facility is a number of years away.
In addition, the report says a number of residents do not have an individual care plan and that patients do not have access to a range of therapeutic services based on their needs.
The report does note, however, that patients expressed satisfaction with nursing staff, reporting that they were very helpful.
Also, the report says St Otteran’s Hospital, which provides care for about 97 residents on the outskirts of Waterford, is continuing to provide care in outdated facilities. While the hospital had begun to close some older wards, it notes that at the time the overall number of residents remained unchanged.
Some mental health facilities at large acute hospitals also came in for criticism. For example, the report says it was disappointing that no progress had been made at the Mater hospital’s acute psychiatric unit to provide multidisciplinary care. “There was no current action plan to address the deficit,” the report says.
Similarly, the report raises concern at aspects of care at Waterford Regional Hospital’s department of psychiatry. It says the service is lacking any occupational input “which causes serious deficits in the area of assessment and therapeutic activities” for patients.
It notes that the department had “serious difficulties” in meeting the requirements of official regulations for approved centres in 2007. The inspections – both announced and unannounced – took place during the latter half of 2008.
* The inspection reports are available to view at the Mental Health Commission’s website, mhcirl.ie
