Psychiatric health: The number of people being committed to a psychiatric institution against their will should be at least halved, Dr John Owen, chairman of the Mental Health Commission, said yesterday.
He said compulsory admission rates to mental hospitals were high by international standards, with more than 3,000 people being admitted against their will every year.
The Mental Health Commission was "very anxious" that this figure be reduced as rapidly as possible, Dr Owens said.
Up to 12 per cent of admissions to psychiatric units are involuntary, accounting for 100 per 100,000 population of those "at-risk" of being certified. The corresponding figure in some EU countries is as low as 25 or 35 per 100,000 population.
Admitting a patient to hospital without their permission caused "enormous trauma" to the patient and the family and could have long-term consequences, Dr Owens said. It was also "a considerable infringement of people's basic rights".
"We need to radically change our approach to the delivery of mental health services." He said he hoped that the introduction of a section of the Mental Health Act 2001 would reduce the rate of involuntary admissions.
Under the Act, all involuntary admissions must be reviewed by a second examining consultant. Mental health tribunals will review decisions to detain such patients within 21 days of their detention and the option of free legal aid for the patient will also be provided.
Dr Owens said this part of the Act should be in place by the end of the year. Preparatory work for the appointment of mental health tribunals and the drawing up of guidelines and protocols was now underway, he said.
He was speaking at the launch of the Mental Health Commission's strategic plan for 2004-2005. The Mental Health Commission is an independent body charged with establishing and maintaining high standards and good practices in the delivery of mental health services.
The report highlighted the lack of funding for mental health services. While up to 30 per cent of all health disability was related to mental health problems, mental health services received only 6.8 per cent of the health budget.This was a decrease from 10.6 per cent in 1990.
Dr Owens said this shortfall had hindered the development of community services, as well as services for children, adolescents and elderly psychiatric patients.
"Other challenges include addressing the gaps and deficiencies in services for homeless people with mental illness, in forensic psychiatry and in mental health services for those with an intellectual disability," he said.
The report called for a move away from the emphasis on hospital beds towards community-based care with teams of well-resourced mental health professionals providing the necessary support.
Mr Tim O'Malley, Minister of State with responsibility for mental health, said he was committed to working with the service providers to bring about the necessary improvements "as resources become available".
Responding to criticism about the lack of funding for the sector, he said some €90 million extra funding had been invested in mental health services since 1997. This funding had been used to provide staff for community mental health services; to increase child and adolescent services; to expand old age psychiatry services; to provide liaison psychiatry services in general hospitals; and to enhance the support for voluntary agencies.
Mr O'Malley said he accepted that Ireland had a "significantly higher" rate of involuntary admission than other European countries but said it was anticipated that the full implementation of the Mental Health Act 2001 would reduce this. "An additional €3 million was allocated to the Mental Health Commission in 2004 to enable it to commence the implementation of these provisions," he said.
