Ms Rosemary Smyth:

I will address this from the perspective of standards and quality assurance and how we ensure that all of our regulatory framework is in line with European and international standards, with the European convention and with best standards. We recently conducted an external review of our regulatory framework and it was found to be quite robust. We compared seven jurisdictions, four within Europe, New Zealand, Australia and Canada. We were unique in being the only jurisdiction that has a stand-alone mental health regulatory framework. We were ahead of other jurisdictions and are the only jurisdiction that has specific rules on restrictive practices such as seclusion and restraint. The Act and these regulations only apply to such inpatient settings and facilities and do not have application for the wider sector. From an assurance perspective, as a regulator, our standards are robust in how we regulate and we have that affirmation from our external review.

On how we keep ourselves up to date, we are a member of a group of international regulators, which most European countries are a part of. We meet annually to discuss various topics. The restrictive practices topic is one that comes to mind and it is very strong in that agenda, together with inclusion of service users. That is something that this group have again looked to Ireland for assistance and help on as we have been seen to be the leader in including service users in our planning, in preparing our documentation against which we regulate.

On staffing levels, we look to other jurisdictions. Workforce planning came up in the Joint Committee on the Future of Mental Health Care, as well, in that is there is no benchmark on what should be the appropriate staffing levels within mental health services. The UK, in its National Institute for Health and Care Excellence, NICE, guidelines, provides some guidance on acute units and what the staffing should be there. We defer to those guidelines and have our standards at what we think should be the appropriate number of people on these units.

On the levels of suicide, that is something we cannot really comment upon, because sudden and unexplained deaths are reported to us but the determination is not made by us as to whether it is suicide. That falls to the coroner. We are, however, working with the National Office for Suicide Prevention. Dr. Dodd has recently taken up post as the clinical lead there. We have met with him and are looking to do some joint work on international standards and the reporting of suicides, because there are many areas that could be developed in a better way here and learnings to be taken. This is something that we intend to pursue with the National Office for Suicide Prevention.