More than 1,200 vulnerable people ‘at risk’ unless residences regulated

The safety of more than 1,000 highly vulnerable people with severe mental health illnesses cannot be guaranteed unless their residences are regulated, the inspector of mental health services has warned.

Dr Susan Finnerty, in a hard-hitting report published on Thursday, warns "a sizeable cohort of approximately 1,200 people" with often severe and complex mental health difficulties is "at risk of abuse and substandard living".

She found “continuing breaches of human rights” in the places where they live, including the right to privacy, to choose where they live, to live independently with supports, to access appropriate rehabilitation and recovery services and to a clean, well-maintained home”.

These adults “have enduring mental illness or intellectual disability”.

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“Most are unemployed, socially isolated and many do not participate in civil and political processes. They are vulnerable people,” she says. “I cannot stress enough the need for these residences to be regulated to protect the safety of people who live in them.”

Inspections

Although not required to inspect them, as they are unregulated, the inspector has done since 2005.

This report, for 2018, is the second of three in a three-year programme to visit all 118 centres. A total of 54 were inspected last year.

Many residents moved into these as part of the process of de-institutionalisation in the 1980s when large psychiatric hospitals were closed. Department of Health policy says each should have no more than 10 residents. This is no longer considered best practice however and the HSE says each should have no more than four residents, each with their own room.

Dr Finnerty found 43 per cent of residences did not provide single rooms for all residents.

“A startling and disturbing finding was that 91 per cent of residences that had shared rooms did not provide any privacy [not even curtains between the beds] within the shared bedrooms. This is in clear breach of the right to privacy and is unacceptable in any healthcare facility,” she says.

Almost one-fifth (19 per cent) of residences “were in such poor condition that it showed disrespect for residents’ dignity” and less than half (46 per cent) were considered to be “in good condition”.

A residence in the west was “poorly maintained and neglected in appearance” and though all residents had their own rooms, all bedrooms “smelled musty” and there was a “general air of neglect externally and internally”.

Little progress

In conclusion, Dr Finnerty writes: “There has been little progress in addressing the rights of people with mental illness who live in 24-hour supervised community residences. The number of residents and the number of residences have not decreased significantly since 2005.

“Needs assessments indicate that if the appropriate resources were in place, many could move to smaller more independent accommodation but this is not happening, due in part to lack of appropriate housing, not enough rehabilitation teams and inadequate staffing on rehabilitation teams.”

Regulation would empower the commission “to enforce changes where deficits and risk are found, protect the human rights of people living in the residences and help mental health services” care and treat them in line with best practice.