Mental health: Poor funding of mental health services is contributing to the high rate of psychiatric patients being detained against their will, a State watchdog report is expected to warn tomorrow.
The first annual report by the Inspectorate of Mental Health Services will say long-established plans to move from institutional care to community-based care are moving too slowly and need to be speeded up and adequately resourced.
Community-based services help to minimise the risk of detention and defuse crisis situations which result in patients being admitted to psychiatric hospitals against their will, the report will warn.
It is also expected to announce plans to develop rules for the use of seclusion, restraint and electroconvulsive therapy in mental health services.
The inspectorate is to begin closely monitoring the rate of involuntary admissions over the next year and will ask service providers to take steps to reduce the risk of repeat involuntary admission of vulnerable patients.
Under new powers contained in the Mental Health Act (2001), services may lose their registration if they fail to uphold sufficient standards. Up to 12 per cent of admissions to psychiatric units are involuntary, accounting for 100 per 100,000 population of those "at-risk" of being certified.
The corresponding figure in some EU countries is as low as 25 or 35 per 100,000 population.
The report is also expected to highlight the lack of funding for mental health services.
While up to 30 per cent of all health disability is related to mental health problems, mental health services received only 6.8 per cent of the health budget last year. This was a decrease from 10.6 per cent in 1990.
Funding shortfalls have slowed down progress in the development of community services, as well as services for children, adolescents and elderly psychiatric patients, according to the Mental Health Commission, the State body responsible for maintaining standards in the sector.
Unlike the old Inspector of Mental Hospitals - who is due to publish a final report in the coming weeks - the new Inspectorate of Mental Health Services will have the power to inspect a wider array of services, including those for children, adolescents and the intellectually disabled.
The inspectorate is headed by Dr Teresa Carey and includes assistant inspectors drawn from consultant psychiatry, psychiatric nursing, clinical psychology, occupational therapy and social work. It is beginning to inspect services and will provide its first comprehensive report next year.
It is understood that members of the inspectorate have met service providers already and told them they will seek clear undertakings to address immediate issues and realistic plans to address more long-term projects.
Tomorrow's report will also raise questions over the quality of statistics available from mental health services and will say it requires more detailed information on resources and activity.
The inspectorate is also expected to support reservations expressed by the Mental Health Commission regarding the Criminal Law (Insanity) Bill (2002).
It will say the new legislation should not transform general psychiatric units into secure facilities, infringing the rights of all patients to treatment in the least restrictive environment possible.
The report is also expected to call for legislation to protect the rights of vulnerable adults, such as those with enduring mental illness, who are highly dependent and lack the capacity to make decisions regarding their lives.
