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Report of the Inspector of Mental Hospitals 1999

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Report of the Inspector of Mental Hospitals 1999 Report of the Inspector of Mental Hospitals for the year ending 31st December, 1999 BAILE A THA CLIATH ARNA FHOILSIU AG OIFIG AN tSOLA THAIR Le ceannach dõÂreach o n OIFIG DHIÂOLTA FOILSEACHA N RIALTAIS, TEACH SUN ALLIANCE, SRA ID THEACH LAIGHEAN, BAILE A THA CLIATH 2, no trõÂd an bpost o FOILSEACHA IN RIALTAIS, AN RANNO G POST-TRA CHTA, 4-5BOÂTHAR FHEARCHAIR, BAILE A THA CLIATH 2, (Teil: 01 - 6476834/35/36/37; Fax: 01 - 4752760) no trõ aon dõÂolto ir leabhar. ÐÐÐÐÐÐ DUBLIN PUBLISHED BY THE STATIONERY OFFICE To be purchased directly from the GOVERNMENT PUBLICATIONS SALE OFFICE, SUN ALLIANCE HOUSE, MOLESWORTH STREET, DUBLIN 2, or by mail order from GOVERNMENT PUBLICATIONS, POSTAL TRADE SECTION, 4 - 5 HARCOURT ROAD, DUBLIN 2, (Tel: 01 - 6476834/35/36/37; Fax: 01 - 4752760) or through any bookseller. ÐÐÐÐÐÐ £8.00 \10.16 (Pn. 8606) ISBN 0-7076-6484-5 Government of Ireland, 2000 Contents INTRODUCTION¼¼¼¼¼¼¼¼¼¼ v GLOSSARY ¼¼¼¼¼¼¼¼¼¼ vii CHAPTER 1 THE PSYCHIATRIC SERVICES: AN OVERVIEW General Comments on Inspections ¼¼¼¼¼¼¼ 1 CHAPTER 2 EASTERN HEALTH BOARD Cluain Mhuire Family Centre, Dun Laoghaire/Rathdown ¼¼¼¼ 17 Central Mental Hospital, Dublin 14 ¼¼¼¼¼¼¼ 20 Kildare Mental Health Service, County Kildare ¼¼¼¼¼ 26 Psychiatric Unit, James Connolly Memorial Hospital ¼¼¼¼ 30 Psychiatric Unit, St James's Hospital, Dublin 8 ¼¼¼¼¼ 34 Psychiatric Unit, St Vincent's Hospital, Dublin 4 ¼¼¼¼¼ 37 Psychiatric Unit, Vergemount Clinic, Dublin 6 ¼¼¼¼¼ 40 St Brendan's Hospital, Rathdown Road, Dublin 7 ¼¼¼¼¼ 44 St Ita's Hospital, Portrane, County Dublin ¼¼¼¼¼¼ 49 St Joseph's Mental Handicap Services, Dublin Fingal ¼¼¼¼ 53 St Loman's Hospital, Palmerstown, Dublin 20 ¼¼¼¼¼ 57 St Vincent's Hospital, Dublin 3 and Psychiatric Unit, The Mater Hospital 63 Wicklow Mental Health Service¼¼¼¼¼¼¼¼ 68 CHAPTER 3 MIDLAND HEALTH BOARD Laois/Offaly Mental Health Service ¼¼¼¼¼¼¼ 73 Longford/Westmeath Mental Health Service ¼¼¼¼¼¼ 77 CHAPTER 4 MID-WESTERN HEALTH BOARD Clare Mental Health Service ¼¼¼¼¼¼¼¼ 83 Limerick Mental Health Service¼¼¼¼¼¼¼¼ 86 CHAPTER 5 NORTH-EASTERN HEALTH BOARD Cavan/Monaghan Mental Health Service ¼¼¼¼¼¼ 91 Louth/Meath Mental Health Service ¼¼¼¼¼¼¼ 96 CHAPTER 6 NORTH-WESTERN HEALTH BOARD Donegal Mental Health Service ¼¼¼¼¼¼¼¼ 103 Sligo/Leitrim Mental Health Service ¼¼¼¼¼¼¼ 107 CHAPTER 7 SOUTH-EASTERN HEALTH BOARD Carlow/Kilkenny Mental Health Service ¼¼¼¼¼¼ 113 Tipperary Mental Health Service ¼¼¼¼¼¼¼ 120 Waterford Mental Health Service ¼¼¼¼¼¼¼ 124 Wexford Mental Health Service¼¼¼¼¼¼¼¼ 129 iii CHAPTER 8 SOUTHERN HEALTH BOARD Kerry Mental Health Service ¼¼¼¼¼¼¼¼ 133 North Cork Mental Health Service ¼¼¼¼¼¼¼ 137 North Lee Mental Health Service ¼¼¼¼¼¼¼ 141 South Lee Mental Health Service ¼¼¼¼¼¼¼ 144 West Cork Mental Health Service ¼¼¼¼¼¼¼ 148 CHAPTER 9 WESTERN HEALTH BOARD East Galway Mental Health Service ¼¼¼¼¼¼¼ 153 West Galway Mental Health Service ¼¼¼¼¼¼¼ 158 Mayo Mental Health Service ¼¼¼¼¼¼¼¼ 162 Roscommon Mental Health Service ¼¼¼¼¼¼¼ 166 CHAPTER 10 REGISTERED PSYCHIATRIC HOSPITALS St Patrick's Hospital, Dublin 8 ¼¼¼¼¼¼¼¼ 171 St Edmundsbury Hospital, Dublin 8 ¼¼¼¼¼¼¼ 173 St John of God Hospital, Du n Laoghaire/Rathdown ¼¼¼¼ 174 Bloomfield Hospital, Dublin 4 ¼¼¼¼¼¼¼¼ 178 Hampstead and Highfield Hospitals, Dublin 9 ¼¼¼¼¼ 180 Kylemore Clinic, Du n Laoghaire/Rathdown ¼¼¼¼¼¼ 183 Palmerstown View, Stewart's Hospital, Palmerstown ¼¼¼¼ 185 Larch Bungalow, Belmont Park, Waterford ¼¼¼¼¼¼ 187 APPENDIX 1 STATISTICS RELATING TO THE PSYCHIATRIC SERVICES ¼¼¼¼¼¼¼¼ 189 TABLE 1 Number of patients in public psychiatric units and hospitals at 31 December, 1994-1999, excluding patients in de-designated wards ¼ 191 2 Number of patients in public psychiatric units and hospitals at 31 December, 1999 ¼¼¼¼¼¼¼¼¼ 193 3 Rate of hospitalisation per 1,000 of the population, 31 December, 1997-1999 195 4 Admissions and admission rates for the years ending 31 December, 1997-1999 ¼¼¼¼¼¼¼¼¼¼ 197 5 Community residential accommodation at 31 December, 1999 ¼ ¼ 199 6 Psychiatric inpatients in registered psychiatric hospitals at 31 December, 1996-1999 ¼¼¼¼¼¼¼¼¼¼ 201 7 Incidence of seclusion, special nursing supervision and ECT administration in 1999 ¼¼¼¼¼¼¼¼¼¼¼ 202 APPENDIX 2 PROCEDURES QUESTIONNAIRE ¼¼¼¼ 205 iv Introduction To the Minister for Health and Children In pursuance of the provisions of Section 247 and 248 of the Mental Treatment Act 1945, I am submitting to you my report for the year 1999 on psychiatric hospitals and services and the care of patients therein. This is my twelfth report since my appointment in Nov- ember, 1987. In Chapter 1, the report details some general matters affecting the psychiatric services at the time of inspection and highlights the main developments envisaged in the psychiatric services in each health board. The report then proceeds to deal with each individual ser- vice. Each health board is allocated a separate chapter, with a chapter also being devoted to registered psychiatric hospitals. Finally there is a presentation of the latest statistical information on the psychiatric services. I carried out the inspections in all hospitals and services except those in the Eastern Health Board which were inspected by Doctor Liam Hanniffy, Assistant Inspector of Mental Hospitals. Doctor Hanniffy accompanied me on a number of other inspections. The inspections were enhanced by the professional advice and guidance of Mr Michael Hughes, Psychiatric Nursing Adviser to the Department of Health and Children. Ms Anne Tighe of the Department of Health and Children assisted with the compilation of this report. As in previous years, we followed the protocol of first presenting a draft report to the Chief Executive Officers of health boards and the Medical and Administrative Directors of private and voluntary hospitals for their observations. In matters relating to factual errors as pointed out by them our reports were amended and finally prepared for presen- tation to the Minister for Health and Children. The reports presented here are summaries of the final reports. Much fuller and more detailed accounts of our inspections were presented to the Chief Executive Officers of each health board and to voluntary and private hospitals. On behalf of the Inspectorate, I would like to thank the many individuals in the psychiatric services throughout the country who co-operated fully with us in providing all necessary information relating to their services and for affording us access to information requested. Those who wish to obtain more statistical information about the activities of Irish psychi- atric services and quantitative data concerning the facilities they provide, should consult the ``Activities of Irish Psychiatric Services'' published by the Health Research Board in association with the Department of Health and Children on an annual basis. Dermot Walsh Inspector of Mental Hospitals v Glossary A & E Accident and Emergency. ACNO Assistant Chief Nursing Officer. Catchment Area Refers to the area traditionally served by a district mental hospital. In many cases, catchment areas correspond with county boundaries. In Dublin and Cork, the catchment boundaries correspond in most cases with those of the community care areas of the health boards. Clinical Director The clinical director is the consultant psychiatrist responsible for a psychiatric hospital and services in the catchment area served by the hospital. Clinical directors may also be known as resident medical superintendents, see RMS below. CNO Chief Nursing Officer. CPN Community Psychiatric Nurse. CPR Cardio Pulmonary Resuscitation. Day Centre A day centre provides social care for patients and it may also offer treatment. Rehabilitation and activation services may be provided and could include occupational therapy, social skills training and light industrial therapy. Day Hospital A day hospital provides comprehensive treatment equivalent to that available in a hospital in-patient setting for acutely ill patients. Clinics can also be held and a range of investigative procedures performed. The day hospital acts as the focus of psychiatric care in an area and is primarily for active treatment of patients with psychi- atric disorders. De-designation The term used to indicate that a part of a psychiatric hospital has been formally separated from the hospital and its patients are no longer considered to be psychiatric patients. Accommodation for older people and patients with intellectual disabilities in a number of hospitals has been de-designated. DNO Deputy Nursing Officer. ECT Electro-convulsive therapy. ESF European Social Fund. FBAO Foreign body in airway obstruction. vii GP General Practitioner. Integration May refer to the integration of male and female patients in the same ward or the integration of male and female nursing staff or both. Intensive Care Unit A specialised unit within the Mental Health Service providing observation and treatment of patients for whom management on an acute ward is not possible. Long-stay A patient who has been continuously hospitalised for over one year. Mental Health The mental health centre offers both day hospital and day care Centre facilities but has a wider remit than a combined day facility. It acts as the centre of the psychiatric service in a sector and the sector team has its headquarters there. It also provides a number of twenty-four hour care beds for assessment and crisis prevention purposes and the development of a comprehensive mental health centre is a particularly suitable method of moving towards a more community-oriented psychiatric
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