The substandard condition of some long-stay psychiatric accommodation has been highlighted by the Inspector of Mental Hospitals. In his annual report, Dr Dermot Walsh said there were still too many locations where the standard of furnishing and decor was unsatisfactory.
Pointing to an "understandable reluctance" to spend money on old buildings with a limited life, the inspector said the poor quality of some accommodation still could not be excused.
St Senan's Hospital in Wexford was criticised for its failure to improve St Clare's admission unit. Dr Walsh recommended that it be closed immediately.
He also pointed to the "unsatisfactory" standard of general maintenance at St Ita's Hospital, Portrane, Co Dublin, and said the physical condition of a toilet block was "unacceptable".
The female seclusion unit in the Central Mental Hospital, Dundrum, was described as "bleak and intimidating". Our Lady's Hospital in Ennis, Co Clare, the Mental Health Unit at Ballytivnan in Sligo and St Michael's Unit in Tipperary were among the hospitals criticised for their substandard facilities. Tipperary Mental Health Services was criticised for having psychotic patients sharing the same ward as patients with an intellectual disability at St Michael's Unit. Dr Walsh also expressed concern at the prescribing of medication and called for "a more organised approach to prescribing drugs". The inspector said patients' medication should be more frequently reviewed, particularly in the case of long-stay patients.
He pointed out that long-stay patients also ran the risk of remaining confined in hospital in their latter years, when their main impairment was a physical, rather than mental, disability. "Clinical review of long-stay patients, on a regular and systematic basis, is essential," Dr Walsh said. The number of patients in psychiatric hospitals has continued to fall, in line with the commitment to transfer all existing admission/acute units from psychiatric hospitals to general hospitals. The number of patients in psychiatric, in-patient facilities fell from 5,101 in 1998 to 4,768 in 1999. Accordingly, acute admissions to general hospitals increased, accounting for 35 per cent of psychiatric admissions last year. About 10 per cent of psychiatric admissions were not voluntary last year and this figure has remained constant.
A number of new psychiatric units opened around the State last year, and this was welcomed by Mr Walsh. However, the ongoing difficulty in recruiting qualified nurses was highlighted by the report, particularly in the eastern region. The Minister for Health, Mr Martin, welcomed the report and said he would consult the health boards and help them as much as possible to bring about the improvements recommended by the report.
