THE MENTAL HEALTH Commission has warned that services in Ireland could deteriorate further unless the recruitment process for promised community mental health posts is completed this year.
In its annual report for 2012, the Commission said it was “disappointed” that less than a third of the 414 vacant posts had been filled.
“We understand that most of the 2012 posts have been filled now, but this means we are still far behind on recruiting the 2013 posts for which financial allocation has been made,” explained chairman John Saunders.
“There is a real danger that standards of care will fall unless these posts are filled promptly. We welcome the fact that the 2012 allocation seems to have been preserved, but we will only make progress towards getting badly needed community services when this is added to the €35 million allocated for this year, giving €70 million by the end of 2013.”
Some good news
The report outlined the progress made in the past three years in ending the use of outdated and unsuitable buildings for inpatient services. In January this year, there were just 394 beds in older approved centres, compared to 1,352 beds at the end of 2009.
Despite that improvement, Saunders said he was disappointed that “slippage in compliance” with some of the legal requirements attached to service providers’ conditions of operation was revealed during the 12 months. The majority of problems were recorded in relation to privacy and individual care plans necessary for all patients.
“Safe high quality care can only be given if there is a clear individual care plan for each service user, recognising and addressing their individual needs,” according to Dr Patrick Devitt, the Inspector of Mental Health Services. “It is disappointing that the level of compliance with this requirement fell from 62 per cent in 2011 to 52 per cent in 2012.”
In 2012, the Commission used its statutory powers to attach conditions to the registration of nine approved centres. Just two centres of 62 achieved full compliance following inspections. They were the Hawthorn Unit at Connolly Hospital and Willow Grove Adolescent Unit at St Patrick’s University Hospital.
Recovery and Care
A diminished focus on recovery-oriented mental health services was another “serious deficiency” highlighted in the mental health report.
“The concept of recovery – that mental health services are designed to assist in a person’s recovery rather than simply to ‘manage’ their illness – is now well understood but implementation of it remains uneven,” the Commission explained.
Such a service would involve a multidisciplinary approach involving a team of psychologists, social workers, occupational therapists and others. The Commission is optimistic about the HSE’s “promising” Advancing Recovery in Ireland initiative.
No improvement
On issues relating to regulations, rules and codes, the Inspector said there was “no significant improvement” noted last year.
“We were dismayed to discover several examples of inadequate and absent individual care plans, of non-compliance with aspects of the Mental Health Act with respect to involuntary admission and the requirement of Section 60 with respect to medicating without consent,” found Dr Devitt.
He also pointed to the insufficient attention given to governance, problems with the number and variety of staffing, inadequate understanding of the values underpinning mental health legislation and policy, and a weak conceptual grasp of individual care planning.
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