Call for reduction in involuntary detention

The rate of involuntary admission to psychiatric hospitals in the State is well above international norms and must be reduced…

The rate of involuntary admission to psychiatric hospitals in the State is well above international norms and must be reduced, the chairman of the Mental Health Commission has said.

When psychiatric services move more fully from hospitals into the community, then rates of involuntary certification of patients "plummet", said Dr John Owens addressing the annual meeting of the Irish College of General Practitioners in Galway .

"About 11 per cent of all admissions to mental hospitals are non-voluntary. The national involuntary detention rate in 2002 was 98 out of 100,000 (in a population over the age of 16) with considerable regional variations in certification rates. It is the aim of the Mental Health Commission to promote a substantial reduction in involuntary detention rates," Dr Owens said.

The commission anticipates that the part of the 2001 Mental Health Act governing the involuntary admission of psychiatric patients will be implemented in March 2004. However, in a reference to ongoing funding difficulties in the health service, Dr Owens said: "for the new Act to effectively improve on the last one, we must have the proper resources so that involuntary certifications become a relatively unusual phenomenon".

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"The Mental Health Commission is an independent statutory body, the first ever to be responsible for improving the quality of psychiatric services. We are keen to be adequately funded as soon as possible to allow us to radically improve the psychiatric system."

GPs at the meeting expressed surprise and admiration at the achievements of the local psychiatric service in Monaghan, which Dr Owens outlined. He described how the involuntary admission rate in the region had been reduced from 98 per 100,000 to 30 per 100,000 without additional funding. The improvement had been achieved since 1998 by redistributing resources to the point where even severely ill patients are being looked after in their homes or in community facilities.

Dr Owens also outlined how the new committal procedures would work from next March and indicated that five full-time mental health tribunals will need to be in place to fulfil the statutory rights of patients. Those who have been involuntarily admitted to a psychiatric unit must have their cases automatically reviewed 21 days after admission.