Each year more than 2,000 patients - or 10 per cent of overall admissions - are detained on an involuntary basis in psychiatric hospitals. Relative to many other EU countries, Ireland's detention rates are significantly higher. However, new safeguards aimed at providing greater protections for patients' rights are likely to result in a reduction in the numbers being detained against their will.
Under the old system, governed by the Mental Treatment Act (1945), there were few protections for patients and no automatic periodic reviews of detention.
Under the new system that was introduced on November 1st last, if a person is detained in a psychiatric hospital, the Mental Health Commission must be notified within 24 hours.
The commission may appoint a solicitor or barrister to represent the patient, and an independent psychiatrist to visit and assess the patient. Within 21 days of the detention, if the patient has not been discharged, there should be a tribunal hearing. The three members of the tribunal include a legal expert, a consultant psychiatrist and a lay person. The tribunal can affirm the detention or order the patient's discharge. Detailed criteria are laid down in the Act regarding the grounds for detention, such as the person causing a danger to themselves or others.
If the patient's detention is affirmed, and continues to be renewed by the hospital, a tribunal will review the case within 21 days of each renewal. As part of the review, a number of psychiatrists or experts will be involved including the psychiatrist at the psychiatric hospital; an independent psychiatrist who reports to the tribunal on the health status of the patients; and a psychiatrist who sits on the tribunal as a member.