IMPROVING standards of care for patients in psychiatric hospitals have been recorded in the Report of the Inspector of Mental Hospitals.
However, in the report published yesterday, the inspector, Mr Dermot Walsh, who visits every psychiatric hospital and unit in the State at least once a year, found facilities in a small number of hospitals were unsatisfactory and urged them to carry out immediate work.
They included St Patrick's Hospital in Castlerea, one of two hospitals which provide in patient psychiatric care in Co Roscommon. It caters for 70 patients.
Mr Walsh said the quality of care at the hospital was a "matter for concern".
It was inappropriate, he said, that patients should be surrounded by a prison perimeter wall without any definite time set for their transfer to alternative facilities.
The standard of care for long stay patients was unsatisfactory, he said. The accommodation had deteriorated and was in poor condition. Patients received no active rehabilitation, documentary procedures were unsatisfactory and no nursing notes were kept. He said the lavatories were dirty, an underclothing a night clothing were not personalised.
The male geriatric sleeping areas were dirty and untidy. Full bottles of urine in a locker and on a window ledge were observed.
Mr Walsh's report for 1995 included a summary of conditions in each hospital visited.
His report said the decline in numbers of new long stay patients, who had been continuously hospitalised for the previous year, did not necessarily reflect a decline in the incidence and prevalence of psychiatric illness as a whole.
However, it was clear the number of people hospitalised for psychiatric illness had declined greatly in recent years and patients were being cared for in other settings, including community based residences and day facilities.
"Nevertheless," said Mr Walsh, "there is always the apprehension that the rate of provision may not keep pace with the decline in in patient facilities, particularly with the phasing out of the former large mental hospitals and their replacement with short stay acute psychiatric units of smaller size."
The Minister for Health, Mr Noonan, acknowledged the influence of the inspector in the improvements in standards of care in the mental health services.