Significant numbers have been in mental hospitals for over 20 years awaiting community-based care
Carl O'Brien
A significant number of mentally ill patients in institutions have been waiting more than 20 years to receive more appropriate community-based care, a State mental health watchdog warned yesterday.
The newly appointed inspector of mental health services, Dr Teresa Carey, said latest figures showed more than 2,300 patients were in mental hospitals for more than a year.
Some of these patients have resided in hospital for two decades or more, despite a government blueprint in 1984 that recommended that such patients be transferred to community residences where their needs would be better met.
"What concerns me is that in some parts of the country, patients are still being admitted to long-stay wards. That is very often because of a lack of appropriate services in the community," Dr Carey told The Irish Times.
Dr Carey was speaking at the launch of the annual report of the Mental Health Commission, the State body responsible for encouraging high-quality services in the sector.
The document includes the first annual report by the inspector of mental health services, who has a wider remit than the old inspectorate, which was limited to institutions and hospitals.
The chairman of the commission, Dr John Owens, also expressed concern at high levels of involuntary detention to mental hospitals.
Every year, about 2,600 people are admitted to psychiatric hospitals against their will.
International comparisons show Ireland's overall rate of involuntary detention is high, twice that of England and four times higher than Italy.
Dr Owens said he hoped these rates could be cut in half once long-promised mental health tribunals, which will provide for the independent review of decisions to detain a patient on an involuntary basis, are established.
Plans to establish the tribunals and other measures provided for under the Mental Health Act (2001) have been delayed due in part to a Government recruitment embargo. The commission hopes the tribunals will be operating by the end of the year.
"These are of fundamental importance. It will bring us up to date and into line with other European countries. At the moment, we are still operating under mental health legislation which dates back to 1945 and which is violating people's fundamental freedoms," Dr Owens said.
Dr Carey said despite a fall in bed numbers in mental hospitals, the State still had high general admission rates to psychiatric hospitals.
Some 70 per cent of all admissions were re-admissions, which suggested that hospital had brought no lasting benefit to many patients.
She said while many alternatives in the community were superior to hospital-based care, many were unable to meet patients' needs.
"Day centres, by and large have not developed as therapeutic centres for lessening disability and promoting a return to a more independent life," the report said.