Staff in mental health community homes need training in recovery and rehabilitation to help residents have greater independence, a report on services has found.
The report said it was "of utmost importance" that rehabilitation and recovery mental health teams be put in place in the Health Service Executive to deliver services to residents in community-based homes as soon as possible.
The teams were recommended in A Vision for Change, the Department of Health's mental health policy document, but have not been introduced so far.
The report, Happy Living Here . . . A Survey and Evaluation of Community Residential Mental Health Services in Ireland, was led by Dr Donna Tedstone Doherty, senior researcher with the Health Research Board and was launched yesterday by Bríd Clarke, chief executive of the Mental Health Commission.
It looked at 102 residences in three HSE areas and involved interviews with 138 residents.
The average age of the residents was 53 years. Most were single, half had attended secondary school and the majority had a diagnosis of schizophrenia with mild and stable symptoms.
The report said the climate and culture of the residences reflected more those of a "mini-institution" than of a home-like environment, especially in the high support residences.
"It is clear from the findings of the study . . . in the restrictive nature of the residences and the lack of participation by residents in their care and treatment, that the principle of recovery has been poorly embraced or realised in the community residential facilities," it said.
For the principle of recovery to underpin mental health services, the retraining and education of many people will be required, it says.
The perception of the residents regarding life in the residencies was mostly positive, the report said, but "the possibility exists that residents do not expect the basic rights that many people take for granted and, given that they have been in the mental health services for a long time, have come to believe they are incapable of independence".
It said unnecessary rules and regulations encouraged dependency and needed to be revised.
Residents reported in most cases that they got on very well with staff. However, there was evidence of an excess of care.
The study also highlighted the need for local authorities' housing departments to address the requirement of people with mental health problems.
