Patients in mental distress safer in community than in most specialised treatment centres, watchdog says

Patients in acute mental distress are safer in the community than in most specialised mental health treatment centres due to the dilapidated state of the facilities, the sector’s watchdog has said.

Prof Jim Lucey, State inspector of mental health services, said some of the centres designed to treat those with the most serious mental illnesses are “unsafe”.

Of the 66 registered mental health centres in the State, one third failed to meet 80 per cent of the minimum standards last year. Fourteen of those 22 facilities are run by the Health Service Executive.

“They’re not trivial matters, they’re not minor issues. This is a minimum standard,” Prof Lucey said. “We are talking about standards that pertain to the availability of safety, the ability to actually protect people from the risks of acute mental disorder.

“It should be a safer place to go than in the community. But if your centre is overcrowded; if your privacy is impacted; if you can’t access the mental health time and space you need; if, in fact, there are ligatures throughout; if the state of it is frankly not clean, then it is not a therapeutic environment.”

Prof Lucey, who works for the Mental Health Commission (MHC), said people in Ireland “are very aware about what mental health space means”.

“But when you go into these centres it’s overcrowded, it’s frankly unsafe,” he added.

Prof Lucey said mental health is the “most important health agenda in the country” and there is great possibility for recovery if therapeutic services are provided. “It’s certainly the largest unmet need. It’s the commonest cause of death among people under 50 in this country, only rivalled now by road deaths,” he said.

He commended those working on the front line in these centres, stating that they do excellent work. However, he said both capital and human underfunding is resulting in patients not receiving “optimal” care.

In a statement following the publication of the commission’s 2023 annual report last month, a HSE spokeswoman said there had been “significant investment” in mental health over the past three years.

“As part of the capital budget €29.6 million was allocated in 2024, an increase from €27.32 million allocated in 2023 and €17.91 million allocated in 2022,” she said. “We know there are areas needing further improvement, and HSE Mental Health is developing a detailed action plan in response to the MHC findings.”

A spokeswoman for the Department of Health said it was “fully committed to working with the HSE to improve access to acute mental health care services”.