Mentally ill patients are almost three times more likely to be detained in a psychiatric hospital against their will depending on the health board area where they live, writes Carl O'Brien
The Mental Health Commission, established by the Government to maintain high standards in the sector, is to examine the reasons for the disparities, which campaigners have described as an "abuse of human rights".
Every year about 2,600 people are admitted to psychiatric hospitals against their will.
Official figures show the rate of non-voluntary admissions ranges from 134 per 100,000 in the North Western Area Health Board to 52 per 100,000 in Dublin's South Western Area Health Board.
International comparisons also show Ireland's overall rate of involuntary detention is high, twice that of England's and four times higher than Italy.
Dr John Owens, chairman of the Mental Health Commission, told The Irish Times he was concerned by the disparity and wanted to work in conjunction with health boards to bring down the rate of detention.
"We feel this is an urgent issue. People should only be certified if it's essential. We need a quality service which is able to detect illness earlier, before allowing a patient to deteriorate to the extent where the only option is to admit them to a mental hospital," he said.
Amnesty International's policy officer, Ms Fiona Crowley, said the Government was flouting a UN convention, which obliged signatories to deliver high standards of mental health, by allowing such high levels of involuntary detention.
While some health experts have blamed the reason for the detention rates on consultant psychiatrists, the Irish College of Psychiatrists said the reasons were more complex.
A spokeswoman said the figures could be due to a range of factors, including the rate of community services, bed availability and social or demographic factors.
The Irish Advocacy Network, which supports mental health users, said promises to provide safeguards for detained patients in the 2001 Mental Health Act have not materialised because the legislation has not been implemented.
The Act provides for mental health tribunals, which will independently review all decisions to detain a patient on an involuntary basis or extend the detention.
These reviews must take place within 21 days of detention. However, Mr Paddy McGowan, founder of the Irish Advocacy Network, said legislation dating back to 1945 which does not protect the rights of detained patients was still effectively in force.
"A prisoner has more rights than a mentally ill patient under this legislation. A detained patient is deprived of the most basic rights, yet a prisoner can be released on bail or have temporary release," he said.
"I can't understand why the rates of detention vary so much from area to area. Why some health board areas seem to be more open to denying someone their liberty than others is mind-boggling."
The Department of Health, however, says the Mental Health Act will be fully implemented and developments are expected later this year. Work on a new mental health strategy, to replace existing 20-year-old plans, is also due to get underway in the coming months.
It also says it is increasing funding and provided an additional €70 million for mental health services between 1999 and 2002.