Oireachtas Joint and Select Committees

Wednesday, 20 June 2018

Joint Oireachtas Committee on Future of Mental Health Care

Deficiencies in Mental Health Services: Discussion

1:30 pm

Mr. John Saunders:

We have quite high legal costs that in the main relate to the other function of the commission around supporting the mental health tribunals. This is fundamentally a human right. People who are detained against their will have a right to have that detention questioned and that is what the mental health tribunals do. They give a "Yes" or "No" response to those issues. Of course, it could be improved but that is what the Mental Health Act demands and that is what the commission does under the Act.

In respect of the approved centres, thankfully, all the old unfit-for-purpose institutions are gone. We are now dealing with units that are attached to general hospitals. Some of them are quite old. In fact, most of them existed prior to the Mental Health Commission. Our brief under the Act is to inspect them and attach conditions and we do attach conditions. At any one time, a significant number of conditions are in place, which means there are things that people need to improve on. As I said earlier, the staff in those services at a local level bend over backwards to make those improvements because they know they are heading in the right direction if they do so. We must accept that they are there. Often it is the only unit in the county and we cannot just close it overnight because there is no plan B. The other thing to bear in mind around registration is that it is never simply a case of saying a place is providing a perfect service. There is always a dialogue around making changes and improvements. Anyone who works in the system will know that the commission through its inspectorate is very open to that dialogue to make those changes.