Shortage of psychiatric hospital beds - report

The number of beds available for residential and long-stay psychiatric patients in most hospitals does not meet requirements, the Inspector of Mental Hospitals reported today.

In his annual report, Dr Dermot Walsh also said that approximately half of designated acute beds were not being used for acute purposes.

Pointing to the lack of rehabilitation places and the apparent inability of local housing authorities to provide housing for the homeless mentally ill, the inspector also pointed to the inefficient administration of beds and placement difficulties with patients who needed other forms of care.

Wastefulness in the delivery of mental health services was criticised and the inspector urged health boards to examine their work practices.

Dr Walsh said he remained concerned at the relatively high level of involuntary admission and detention. Irish involuntary admission rates were 75 to 100,000 compared to 49 per 100,000 in England and 26 per 100,000 in Italy.

He suggested more frequent and assiduous reviews of the status of those patients admitted involuntary with the least restrictive status employed at all times.

Admitting young people into adult psychiatric units was highly undesirable, said the inspector. This practice occurred because of the lack of appropriate residential places for such young persons who were often out of control, rather than suffering from a formal psychiatric illness.

The Acute Unit at James Connolly Memorial Hospital Dublin was criticised as "structurally unsatisfactory". Dr Walsh recommended a new unit be commissioned to remedy this.

Dr Walsh welcomed the decision to remodel and refurbish part of the central Mental Hospital, Dublin, as the 19th century building within the facility failed to meet even the minimum standards of accommodation for therapeutic purposes.

The number of patients in psychiatric, in-patient facilities fell from 4,768 at the end of 1999 to 4,559 at December 31st, 2000. There were 24,100 admission into public and private psychiatric hospitals and approximately 6,750 were first-time admissions.