THE MENTAL HEALTH Commission’s (MHC) 2021 Annual Report found that independent privately-run inpatient mental health centres typically offer a higher level of care than HSE-run centres.

The report noted that significant investment is required into HSE-run inpatient services to ensure all people have access to a similar standard of inpatient care throughout Ireland.

66 approved centres were  inspected, with the 10 independent and privately-run inpatient centres scoring a higher average overall compliance rate.

The only HSE area that scored higher than the privately operated facilities was Community Healthcare Organisation 5, which covers south Tipperary, Carlow/Kilkenny, Waterford and Wexford.

The MHC has written to the HSE seeking an updated action plan to address the issues raised in its annual report, particularly around premises, individual care plans, and risk management practices.

Chief Executive of the Mental Health Commission, John Farrelly stated: “Publicly-funded mental health services require significant improvement in terms of compliance and funding if we are to create a more equitable health care system for people who need to access inpatient mental health services.”

“Unfortunately, this means that only a select number of people – who either possess private health insurance, or the financial means to pay out of pocket – can access many of Ireland’s high-performing independent centres.”

“Costs should not prevent people from receiving adequate mental healthcare,” Farrelly added.

Premises-related concerns in HSE-run centres were the most widespread issue and were related to both inadequate resourcing and to poor governance arrangements, the report found.

Approximately 89% of approved centres achieved an 80% rate of compliance or higher, compared to 82% of services in 2020.

The compliance rate for premises management was below 60% for all nine Community Healthcare Organisations (CHOs), at an average score of 27%, compared with a 70% compliance rating for the 10 independent providers.

CHO 6, which comprises four facilities in Wicklow, Dun Laoghaire, Dublin South East fared the lowest with a 0% compliance rate.

CHO 8 (Laois/Offaly, Longford/Westmeath, Louth/Meath) scored the worst for providing individual care plans for patients, with a compliance rate of 16.7%.

Staffing was also highlighted as a key issue, with the four facilities in CHO 3 (Clare, Limerick, North Tipperary/East Limerick) having the lowest compliance with staffing guidelines at 25%.

Inspectors highlighted the identification of multiple serious risks and poor environments across five HSE approved centres in Co Cork, which has required repeated focused inspections.

41 Serious Reportable Events were reported to the MHC, relating to 23 centres, while  January 2021 was recorded as the month with the most Covid-19 cases (948).

Of the 19 instances of non-compliance that received a critical risk rating during 2021 – meaning that there was a high likelihood of continued non-compliance and a high impact on the safety or wellbeing of residents – seven of these related to premises.

The report also listed that 471 deaths were reported of people using mental health services in 2021, and 32 children were admitted to 11 adult units (compared to 27 admission to 9 adult units in 2020).