Psychiatrists criticise HSE over 'major deficits' on mental health act

The Irish Hospital Consultants' Association (IHCA) has written to the HSE to tell it that “major deficits exist” in relation to the implementation of part two of the Mental Health Act, 2001 which came in on 1 November.

The act established that all people who are involuntarily detained must have their cases reviewed by a tribunal after 21 days; psychiatrists must seek a second opinion in relation to some mental-health patients; and children and adolescents must be accommodated in designated centres.  

Psychiatrists say that documentation relating to the detention of children has not been received by them and they are getting inadequate notice from the Mental Health Commission about tribunal hearings, which is disrupting their clinics.

In a letter to the HSE seen by Village, the IHCA outlines some of the problems that are still outstanding in relation to the tribunals. The letter, sent 8 December, says, “We have surveyed psychiatrists across all specialities in the country and it is apparent that major deficits exist.”

It states that just a quarter of all psychiatrists treating adults have received written information on where children under 16 will be admitted.

Child and adolescent psychiatrists have received no letters of information on the admission of children, children with learning disabilities, or escorts to transport involuntarily-detained children.

The IHCA also said that most of the additional consultants' posts are not in place even on a temporary basis.

A major deficit is that there are not enough places in designated centres for the detention of children or adolescents. At present there are five beds in Galway in five in Dublin, but the Dublin ones are just from Monday to Friday. The HSE intends that the Dublin beds will be in use seven days a week in 2007, and that 10 beds will be implemented in Galway.

Three psychiatrists to whom Village spoke said that they had received very little notice from the Mental Health Commission for attendance at one of the tribunals. One Dublin psychiatrist had just two days' notice. This meant that she had to cancel her own patient clinic at short notice or allow her junior psychiatrists to do the clinic without her supervision.

The HSE had promised 21 additional psychiatric consultant posts to help with the extra workload the tribunals entail.

These positions have not been filled and Kate Ganter, chairperson of the Irish College of Psychiatrists says, “We understood that this would happen very quickly.”