The number of patients detained against their will in psychiatric hospitals has fallen sharply since the introduction of new safeguards aimed at protecting the rights of people with mental health problems, new figures show.
While an average of around 250 people were being involuntarily detained in hospitals each month under the old system, this has fallen by around a third to 150-160 since the introduction of mental health tribunals last November.
Each year about 2,500 patients - or 10 per cent of all admissions - are detained against their will in Irish hospitals. The relatively high rate of involuntary detention in Ireland has become a major issue in recent years, with campaigners describing it as an abuse of human rights.
However, officials in the Mental Health Commission, the watchdog for the psychiatric care system, have said it is too early to draw any firm conclusions from the numbers. This is because figures may be distorted by the number of transitional cases, or patients who were detained prior to the new safeguards being put in place in November.
All these cases, as well as new patients, are being examined by the mental health tribunals.
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 introduced on November 1st last year, 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, a tribunal hearing should be held.
The three members of the tribunal include a legal expert, a consultant psychiatrist and a lay person. The tribunal can either affirm the detention or order the patient's discharge.
New figures for the first four months of the tribunals' operation show that of the 556 cases heard before a tribunal, 86 were revoked or discharged. There is no breakdown of the grounds upon which cases were revoked. Anecdotally, however, there have been a number of instances where tribunals have not sat within the statutory 21-day limit to hear a patient's case.
In these cases, the tribunal automatically does not not have any standing to hear the case and detention is revoked.
The independent reviews may also address the issue of regional disparities in the likelihood of a patient being involuntarily detained.
Under the old system, a patient with psychiatric problems was almost three times more likely to be detained against their will depending on what part of the State they lived in.
For example, official figures in recent years under the old health board system showed the rate of non-voluntary admissions ranged from 134 per 100,000 people in the North Western Area Health Board to 52 per 100,000 in Dublin's South Western Area Health Board.
Campaigners have claimed the regional disparities have much to do with the treatment method of psychiatrists in different parts of the State. They have pointed out that rates are typically lowest in areas which place an emphasis on more modern approaches such as community-based care and alternative to drug-based treatment.
However, representative groups for consultants say the regional variations may be due to a range of factors, including the rate of community services, bed availability and social or demographic factors.
