Patients restrained or secluded 5,000 times during 2009

PSYCHIATRIC PATIENTS were either restrained or secluded in mental health facilities on more than 5,000 occasions during 2009, according to a new report by the Mental Health Commission.

The figures come at a time when there are hundreds of staff vacancies across the mental health services due to a moratorium on public sector recruitment.

Amnesty International Ireland yesterday expressed concern at the scale of the practices which have serious implications for a patient’s right to dignity, privacy and bodily integrity.

Colm O’Gorman, Amnesty’s executive director, said: “Now that the scale of the use of seclusion and restraint has been identified, services must identify what steps they will take to minimise the use of such practices.”

He also said the staff shortages in some centres point towards a link between the increased use of restraint.

Official figures show almost three-quarters of mental health facilities used physical restraint during 2009.

Less than half of facilities (44 per cent) used seclusion, while about 10 per cent used mechanical means of bodily restraint.

Official rules state these interventions should only be used in “rare and exceptional circumstances” where a resident poses a risk to themselves or others.

Overall, there were 2,855 episodes of physical restraint reported, an increase of about a third over the previous year.

Three centres accounted for more than one-third of all episodes of physical restraint.

These were St Joseph’s Intellectual Disability Service at Portrane, St Vincent’s Hospital in Fairview and the acute psychiatric unit at the Midwestern Regional Hospital in Ennis. All three approved centres recorded large increases in the use of physical restraint compared to 2008.

The biggest single increase in the use of physical restraint was at the Lakeview unit at Naas General Hospital, where the number of incidents of restraint increased from seven to 53, an increase of more than 600 per cent.

Seclusion was also used in many mental health facilities. In total, there were more than 2,500 episodes of seclusion during 2009, a slight decrease on the previous year.

St Joseph’s Intellectual Disability Services and St Brendan’s Hospital accounted for just under 40 per cent of all seclusion episodes. Seclusion was used on almost 700 occasions at the St Joseph’s service, an increase of 152 on the number of seclusion episodes in 2008.

These numbers are likely to fall significantly in 2010, since the opening of a new residential facility at St Joseph’s. This has allowed for the transfer of residents from the Victorian-era building to a modern facility at Portrane.

St Brendan’s Hospital recorded 313 seclusion episodes in 2009 which is a decrease of 192 on the number of reported episodes in 2008.

The length of time an episode of seclusion lasted varied across different hospitals.

Official rules state that a seclusion order must not be made for a period of time longer than eight hours, but it can be extended up to 72 hours in some circumstances.

The majority (86 per cent) of seclusion episodes lasted eight hours or less. Eight per cent of episodes of seclusion lasted more than 16 hours and only 1 per cent more than 72 hours.

In the Central Mental Hospital, almost 70 per cent of seclusion episodes lasted longer than 16 hours.

It also had a relatively high percentage of seclusion episodes (17 per cent) lasting for more than 72 hours.

While cases of seclusion and restraint increased in many hospitals, they fell significantly in others. The numbers of cases of seclusion at St Bridget’s Hospital in Ardee fell by 40 per cent, while St Luke’s Hospital in Clonmel recorded a 35 per cent decrease.