Mr. John Farrelly:

Dia dhaoibh go léir. I welcome the opportunity to appear before the committee with my colleagues Dr. Susan Finnerty, Inspector of Mental Health Services, and Ms Rosemary Smyth, director of standards and quality assurance.

The Mental Health Commission is the regulator for mental health services in Ireland. It is an independent statutory body. Its mandate is to promote, encourage and foster the establishment and maintenance of high standards and good practices in the delivery of mental health services. Under the 2001 Act, the statutory scope of mental health regulation for us is limited to inpatient services. Therefore, we have quite a limited scope in terms of the full mental health service. We perform a critical function in vindicating the rights of people who are put into mental health units against their will or in an involuntary way.

Over the course of the period of Covid-19, we monitored 181 residential mental health services, comprising 67 regulated inpatient centres and the rest were community hostels. The written submission of the Mental Health Commission sets out the number of concerns identified as part of our role in monitoring the progression and impact of Covid-19. We found that staff on the ground, people in the unit, the clinical staff and the management pulled together well. We could not say it was a success because people died but I have to say that the mental health services and the professionalism of staff protected many people. I want to emphasise that.

We found that the national governance was one to three weeks behind the services themselves. That is fair enough in that the services knew what was happening in the here and now. We found issues with facilities with shared accommodation and a limited ability to isolate and there was a lack of public health guidance, specifically for mental health settings. We found delays and inconsistencies in testing in the early phase of lockdown. We have to be frank that people were caught on the hop. From what we could see, resources were taken out of mental healthcare provision and diverted into other parts of the system, based on the thinking at that time. There were also delays and inconsistencies in testing, as well as inconsistency in the continuity of services. Community-based services were also suspended. Those were the key issues for us.

To come back to the main point, we have been giving evidence to two Ministers for Health, the HSE and basically anyone who would listen about our mental health services for the past ten to 15 years. It is clearly documented and transparent and it is in the public domain. Covid-19 has shown us that we need to address this issue, we need to put money into infrastructure to make sure buildings are fit for purpose for people, we need to put money into making sure our services are well staffed and we need to set about building a proper community mental health service in Ireland.