Consultants warn of lack of readiness for Mental Health Act

Hospital consultants have expressed concern at readiness for the full implementation later this week of the Mental Health Act 2001 and the introduction of new mental health tribunals.

The Department of Health and the Health Service Executive (HSE) have said that the tribunals, which will review the cases of persons detained involuntarily in psychiatric hospitals and other elements of the legislation, will come into effect from tomorrow despite a last-minute call by the Irish Medical Organisation (IMO) for it to be deferred.

The Irish Hospital Consultants Association (IHCA) said that the new tribunals would be "operating on a wing and a prayer" for several months at least due to a lack of administrative preparation by health service management.

The HSE said yesterday that it was prepared for the implementation of the legislation although in some cases there would be interim measures in place.

The IHCA said that management were now seeking to put in place "panic station measures" to get around the lack of advance preparation for provisions set out in legislation six years ago.

The IMO said there was anxiety among doctors at the administrative arrangements in place.

Several hours of talks last Friday between the HSE and medical bodies over the introduction of the new legislation ended inconclusively. Further contacts between the parties are scheduled to take place today. However, it appears certain that the legislation and the mental health tribunals will come into operation as scheduled tomorrow.

Both the IMO and the IHCA have claimed that 20 additional consultant psychiatrist posts, to facilitate the tribunals, have yet to be advertised.

They also say that new units for adolescents and for persons with learning disabilities who are detained have yet to be opened.

IHCA secretary general Finbarr Fitzpatrick said that from tomorrow an independent second opinion would have to be secured regarding every person whose detention was changed from voluntary to involuntary and for the provision of electroconvulsive therapy.

He said that these would have to be genuinely independent and carried out by psychiatrists outside the immediate area. He said that while there were sufficient doctors prepared to carry out such work, there was no central logistical support in place to commission these second opinions.

The HSE said yesterday that it had been working on its readiness programme for the implementation of the Mental Health Act since July 2004.

It said that every mental health service in Ireland had received additional funding and staff allocation, and that areas of high population growth or deprivation had been particularly targeted.

The HSE said that €26.2 million had been provided in 2006 for the establishment of 18 teams in adult psychiatry in addition to 14 team enhancements, eight teams in child and adolescent psychiatry, six additional posts in old age psychiatry and two teams in forensics.