THE MENTAL Health Commission has found the Health Service Executive to be in breach of the Mental Health Act over its care for a 39-year-old male psychiatric patient. The man has been in custodial care at an acute psychiatric unit in Ennis, Co Clare, since July 2008, and round-the-clock security costs to the HSE for the man run at €1,000 per day. The estimated security bill for the man since July 2008 to date is €1.3 million.
Now, in its 2011 report on the unit, the commission reports that “the individual had been inappropriately placed in the unit for some years and efforts to place the individual in a more appropriate secure setting had not progressed”.
The commission found the HSE to be in breach of sections 16 (1) and (2) of the 2001 Mental Health Act as the case formulation and specification of therapeutic services and programmes for the man were not elucidated in a manner to support and satisfy those aspects of the Act.
The report found that two security personnel were assigned to the man at all times during the day, with a second shift of two personnel to be with him during the night. The report records that the security personnel “were thus the main interpersonal contact available to this patient”.
“The security staff were personable and gave a clear account of the patient’s routine and their role in providing custodial care.”
The man suffered a serious brain trauma during an assault. As a result, the frontal lobe on the left-hand side of his head was wasted, and Ennis District Court was told that this causes disturbances in mood, will, understanding and changes in understanding of societal norms. Overall, the commission found 18 separate breaches concerning the unit, with staff reporting “a significant increase in physical assaults on staff in 2011”.
The report recorded that one patient experienced the unit “as being an intimidating environment at times with fear of verbal or physical assault”.
Last night, general secretary of the Psychiatric Nurses Association Des Kavanagh said the acute unit was inappropriate for the man.The HSE declined to comment.
