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HSE doubles amount of admission officers for mental health patients

Despite the increase, the number of admission orders made by authorised officers has fallen.

THE HEALTH SERVICE Executive has increased the number of Authorised Officers (AOs), however, the number applications for involuntary admissions to mental health units made by AOs has fallen since last year.

Last July, there were just 40 AOs providing a service in Ireland. The HSE told TheJournal.ie that as of June 2014, there are now 12o AOs working in Ireland.

Under the Section 9 of the Mental Health Act 2001 an Authorised Officer (AO) is a staff member of the mental health services who is authorised to make an application to a registered medical practitioner for the involuntary admission of an adult to hospital.

At the outset of the Mental Health 2001, it was envisaged that the AO would play a central role in the application and admission of a person with a mental disorder to hospital.

An AO was to be from a mental health background and would be brought in when a situation arose.

Admitted to hospital 

The idea is they would be tasked with giving information about alternative options and work with the family, GP and gardai if needed, in doing something other than hospitalising the person, but if in the end there is no alternative, it would be the AO and not the family that would make the application to admit the person on an involuntary basis.

Experts argue that having a loved one sign in a family member can have devastating affect on trust between family members. The AO was to remove some of the pressure placed on family members, but figures show that families continue to be the largest group that sign in people to a mental health unit.

The HSE said there are currently 120 AOs on the national register.  The breakdown of the register is as follows;

  • Dublin Mid Leinster – 26
  • Dublin North East –  26
  • West – 33
  • South – 35

Figures for 2013 show that even though there has been an increase in the number of Authorised Officers, the number of involuntary admissions they are responsible for has remained relatively unchanged since 2012.

In 2012, the spouse, civil partner or relative accounted for over 57 per cent of all involuntary admissions.

Family members

This category made 901 applications to have a loved one detained in a mental health unit on an involuntary basis.

This was followed by the gardaí, who made 22 per cent of applications, while other persons accounted for 13 per cent.

Just 127 involuntary admissions were made by Authorised Officers in 2012, just 8 per cent of all admissions.

In 2013, despite there being an increase in the number of AOs, the number of involuntary admissions has actually fallen from 127 in 2012 to 121 in 2013.

Family still account for 57 per cent, while applcations made by the gardaí had also fallen to 19 per cent. Involuntary admissions by other persons increased from 13 per cent to 16 per cent, accounting for 259 of the 1,591 cases.

The HSE said it is currently seeking candidates for a further Authorised Officer training course which will take place over the summer (approximately 20 places on each training course).

They said that the role of the Authorised Officer has made a “positive contribution to service delivery; in facilitating the least restrictive alternative to involuntary admission to hospital, in taking the task of making an application for admission from family members and providing a source of knowledge regarding the implementation of the Mental Health Act 2001 to Registered Medical Practitioners and the public”.

The HSE stated that AOs have resulted in “a significant reduction in the number of involuntary patients”.

The latest report from the Mental Health Commission report shows that there were 1,591 involuntary admissions of adults to a mental health unit in 2013.

Read: More than a dozen children admitted as involuntary patients in 2013>

Read: The ‘defacto detained’: How voluntary patients can be held without review>

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Christina Finn
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