VULNERABLE PRISONERS at risk of self-harm and suicide are being placed in safety observations cells for weeks at a time because there is still no high-support unit at Mountjoy Prison, a new report by the mental health regulator says.
Inspectors at the Mental Health Commission say they are “concerned” that observation cells are the only resources available to treat vulnerable prisoners at Mountjoy. They also criticise prison authorities for giving nursing staff the authority to place prisoners in the cells without the necessity of a four-hour review, which is standard practice at approved mental health facilities.
Safety observation cells are designed to accommodate prisoners who require frequent observation for medical reasons or because they are a danger to themselves. They are designed to be a short-term measure and not to be used to alleviate mental illness.
The inspection report recommends that prisoners “should only be placed in the safety observation cells as a last resort, and appropriate human rights safeguards should be established”. It says a high-support unit should be commissioned as soon as possible.
The inspection, which was carried out on April 6th, is one of 27 inspection reports published yesterday by the commission, which was established in 2001 to regulate the mental health sector.
Three of the approved mental health centres were awarded full marks from commission inspectors: St Stephen’s Psychiatric Hospital in Cork and St Patrick’s and St Edmundsbury hospitals in Dublin. Many other centres showed incremental improvements while some remain causes for concern despite several years of critical inspections.
“The issue for many is not poor buildings. It is the absence of patient care plans, the lack of progressive attitudes from some staff, and mixed quality of clinical leadership,” said Hugh Kane, chief executive of the commission.
The commission published inspection reports covering 22 approved mental health centres and five other services, which included the mental health services offered at Mountjoy prison.
Inspectors criticised Mountjoy for not having a multidisciplinary clinical team, access to clinical psychologists, occupational therapists or social workers.
Mr Kane said this was problematic because prisoners have the same right to mental health services under the law as the general public. He said prisoners have a higher need than most.
Mr Kane also issued a plea to the Government to protect mental health services from cutbacks.
“Everyone can see that the economic situation is very bad in Ireland at the moment and vulnerable people are suffering mental health problems as they lose jobs or face debt. It is important investment in services is protected,” said Mr Kane. Commission inspectors found poor standards at other facilities, including the day hospital in Cavan General Hospital, which was “cramped” and where “nursing staff were stretched to provide a basic service”.
“There was not a suitable number of staff to carry out any meaningful therapeutic engagement with service users. Long-term patients did not have regular formal multidisciplinary team reviews,” said the report.
Staff at St Senan’s Hospital in Wexford were praised for maintaining a high level of clinical care and treatment for residents despite a poor quality building.
“It continued to be of concern to the inspectorate that residents remained accommodated, cared for and treated in an old Victorian building which was dilapidated, depressing and unfit for human habitation. There should be provision for the delivery of a modern mental health service for the residents of Wexford county,” the report said.