The Mental Health Commission, independent watchdog for the mental health sector, will seek to recruit consultant psychiatrists from abroad to take part in review panels for involuntarily detained patients after talks with the main representative body for Irish consultants broke down yesterday.
Negotiations have been taking place for almost a year between health authorities, the commission and the Irish Hospital Consultants Association (IHCA) on plans to set up mental health tribunals to help safeguard the rights of thousands of patients detained against their will in psychiatric institutions.
More than 3,000 psychiatric patients are involuntarily detained in psychiatric hospitals each year. Ireland has one of the highest rates of involuntary detention in Europe - a source of concern for human rights campaigners and patient support groups.
These tribunals, which will review all decisions by consultants to involuntarily detain patients, will consist of three members: a chairperson, who must be a lawyer, a consultant psychiatrist and a lay member.
While lawyers and lay people have been recruited, the IHCA has instructed members not to apply for the positions.
The IHCA says consultants need greater staffing back-up to be able to adhere to very strict timescales accompanying the new tribunals. Failure to adhere to the codes may leave consultants or clinical directors liable to fines of up to €1,500 or two years in jail.
Following the expiry of a deadline set for agreement on staffing the tribunals yesterday, the commission's chief executive, Brid Clarke, yesterday told The Irish Times that the delays were undermining the rights of almost 3,000 psychiatric patients involuntarily detained in hospitals each year.
As a result, she said it intended to re-advertise for consultant psychiatrists to the mental health tribunals.
"We will be advertising within Ireland and internationally and will be providing applicants with the opportunity of full-time/part-time appointments and engagement on a sessional and case-by-case basis," she said.
Minister of State with responsibility for mental health Tim O'Malley expressed his "deep frustration" at the actions of consultants who were "obstructing reform".
"People who are detained against their will for psychiatric care and treatment are among the most vulnerable in our society in terms of their human rights," he said. "It is completely unacceptable that those who should be the guardians of those rights, their treating consultants, are the ones who are obstructing reform."
He said offers of greater resources had been made to consultants, but their stance was "baffling" and cast doubt on their willingness to co-operate with the proposed reforms.
The IHCA and other consultant representative bodies say the mental health sector is understaffed and that not enough clinical back up is available for them to participate in the tribunals.
They point to the recent Inspector of Mental Health Services report, which recommended establishing the equivalent of up to 27 consultants posts, according to estimates by consultants.
It is understood that in talks on tribunals, the Health Service Executive proposed 13 new consultant posts, with the support of junior medical staff and other professionals, at an estimated cost of €6-€10 million.
