Very little progress has been made in Waterford towards providing an acceptable modern mental health service, despite deficits having been highlighted in the past.

That’s according to Dr. Susan Finnerty, Assistant Inspector of Mental Health Services, who was responding to the Mental Health Commission’s annual report.

The report states that there has been a significant reduction countrywide in the number of people admitted on an involuntary basis to in-patient mental health units. However, the MHC is concerned that while progress has been made in the performance and quality of care in such centres, considerable improvements are still necessary.

Last year 2,126 people were treated as involuntary patients in approved centres. But the report states that while that 25 per cent reduction on 2005 was notable and welcome, further detailed analysis of the factors leading to the reduction was required and would be undertaken by the Commission in the coming months. The Mental Health Act 2001 provides for patients’ right to an automatic independent review of an involuntary admission. There were 2,248 such reviews, mental health tribunals, held in 2007.

Waterford has two approved centres: St. Otteran’s Psychiatric Hospital with 97 residents and a 44 bed admission unit in Waterford General Hospital. Dr. Finnerty summarised the report’s findings on Waterford by saying: “Very little progress has been made in Waterford towards providing an acceptable modern mental health service despite deficits being highlighted in previous reports. Considerable investment is required in resourcing the service in staff and capital developments and also in assisting the service to meet basic standards in mental health care such as provision of privacy and dignity, care planning, and development of policies and protocol.”

Speaking at the publication of its sixth Annual Report, including the report of the Inspector of Mental Health Services, Brid Clarke, Chief Executive Officer of the MHC said: “2007 was a milestone year for mental health services in Ireland. It was the first full year of the implementation of the Mental Health Act 2001 and this has had a significant effect on the delivery of mental health services in Ireland. While we acknowledge that changes have taken place in a lot of approved centres there are a still a number of centres which are not operating to best practice. It is the goal of the Commission to continue to promote high standards during 2008 and onwards.”

Dr. Finnerty said: “The provisions of the Act have introduced immense change for in-patient treatment and most services had considerable difficulty in meeting the requirements for approved centres. However there were indications at the end of 2007 that most services were actively planning and moving towards full compliance and there is no reason why this should not be realised in 2008.

“Our overriding concern is that the staffing of mental health teams continues to be painstakingly slow”, continued Dr Finnerty. “The HSE restrictions on recruitment have been particularly difficult for the mental health sector and despite this serious and urgent need, the appointment of key mental health staff, such as occupational therapists and social workers has not happened and in many areas service users are still unable to access basic mental health care.”

Commenting on the outcomes of inspections of all 61 approved centres Dr Finnerty said: “Several concerning themes emerged from inspections including the fact that admission wards remain in old psychiatric hospitals, that some facilities are in poor condition, there is a lack of child and adolescent mental health services and finally the lack of service user involvement in their own care plans continues to be a problem.”

“The change towards a quality national mental health service in 2007 remained piecemeal and disappointingly slow. The wait continues for adequately staffed adult and child and adolescent community teams, the closure of unsuitably large psychiatric hospitals, the arrival of a comprehensive national forensic service and the development of even a minimal service for people with intellectual disability and mental health problems,” she concluded.