James Browne (Wexford, Fianna Fail) | Oireachtas source

I wish to discuss the implementation of regulation of community-based mental health care services. Last week the Mental Health Commission, MHC, published reports on 24-hour nurse supervised residences after inspecting 43 of these units. This is the first publication of inspection reports in this area. It is part of a three-year programme that will see the inspection of all 24-hour residences. The findings were both illuminating and disturbing. The Mental Health Commission found serious deficiencies in many of the residences. Residents were not free to leave in six residences, which had locked doors. There was no access to a kitchen to make tea, coffee or snacks in 19 residences. Residents were unable to lock their bedroom doors in 33 residences. More than half - 25 residences - had more than ten beds although ten is the maximum number of beds recommended in A Vision for Change. Only 19 of the 43 residences were in good physical condition. Eight required urgent maintenance and refurbishment. Only 25 residences offered all residents single-room accommodation. Furthermore, two residences had bedrooms which catered for four people. In residences with shared rooms, 58% had no privacy between beds or within the bedrooms. A rehabilitation team provided services for only 51% of these residences.

There is no reason to believe that the residences not yet inspected are any better. Dr. Susan Finnerty, inspector of mental health services, was clear in her unease at the findings, saying that it is concerning that some of our most vulnerable citizens, many of whom have spent decades in psychiatric hospitals, are now being accommodated in unregulated, poorly maintained residences that are too big, are institutionalised, restrictive and are not respectful of the privacy, dignity and autonomy of residents. The chairman of the Mental Health Commission, Mr. John Saunders, stated that ideally, there should be a care pathway where people move from hospital to highly supported accommodation, graduating to more independent settings as they gain skills and confidence. However, at present there is a serious lack of suitable accommodation options and rehabilitation and recovery staff to enable service users to move through the different stages of recovery and progress towards the goal of independent, community-based living. Many people have to remain in highly supported accommodation.

The Mental Health Commission justifiably used very strong language in its conclusion. It highlighted how a lack of regulation means people in 24-hour residences are at risk of abuse and substandard living conditions and treatment. Does the Minister of State agree with the findings of the report and its conclusions, and how does he intend on acting on the issues raised in the report?

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