Mental health watchdog flags staffing shortages at CMH
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Existing capacity at the country’s only secure mental health hospital is not being used because of significant staff shortages, according to an oversight body.
The Mental Health Commission (MHC) also said these shortages meant the needs of residents in the Central Mental Hospital (CMH) were not being met.
The watchdog said mandatory rules it introduced in January 2023 were not being adhered to at the forensic hospital, with overall compliance rates falling from 82% in 2022 to 69% in 2023.
The CMH moved from a Victorian facility in Dundrum, south Dublin, to a state-of-the-art campus in Portrane, north Dublin, in November 2022.
The MHC inspection was conducted over four days in July 2023.
The facility takes people with severe psychiatric illnesses referred to it under the Criminal Law (Insanity Act) 2006 and the Mental Health Act 2001.
The report said there were 130 high and medium secure beds at Portrane, but only 101 were in use at the time of inspection.
“While there was an adequate skill mix of staffing available, there were not enough staff to meet resident needs,” the report said.
“There were staffing shortages across medical, nursing, occupational therapy and psychology teams.”
Two wards were not open: one of two wards in the Mental Health Intellectual and Development Disabilities unit and one of two wards in the Female unit.
The report said the operational capacity of the CMH, which is part of National Forensic Mental Health Service (NFMHS), was 108 - compared to 102 in Dundrum.
Portane has a potential capacity of 170, but in addition to the above wards, the specialist children's unit has not yet opened.
The MHC has previously stated that even at 170 beds Ireland would still have a third of the average number of beds per 100,000 people that pertains in modern European states.
The MHC report said the staffing shortages have had “multiple impacts” within the CMH including timely access to therapies, with a “significant waiting list” for psychology services.
Otherwise, the report complemented the accommodation, facilities and general environment at the campus as well as the communal centre, known as the Village.
The village has a coffee shop, a multi-faith prayer room, a hairdresser, concert hall, a large sports hall, a gym, a woodwork suite, a music room, kitchen and arts and crafts room, as well as communal gardens, gardening areas and a paddock.
It said residents can avail of work and training placements at the village.
Residents told the MHC they were pleased with the new premises and said it was a “vast improvement” on Dundrum. Residents were complimentary towards staff and the food.
In a statement, the HSE said the NFMHS welcomed the report and that an action plan was in place.
It added: “Through 2023, the National Forensic Mental Health Service has undertaken a series of recruitment campaigns: 144 new staff were recruited to the service during 2023 - 51 registered psychiatric Nurses, 21 health care assistants as well as 20 registrars formed part of this new staff cohort.
“Substantial positive progress to recruit staff was made in 2023. The CMH has reached the agreed threshold of staff numbers required for [its] operations.”