Litany Of Failures Dog Mental Health Act

A list of concerns over the recently introduced mental health tribunals and the Mental Health Act, 2001, has been sent to health officials at the Health Service Executive (HSE) and the Mental Health Commission (MHC).

Irish Medical Times understands that a confidential document, from medical practitioners working with the new tribunals has highlighted a large number of issues that have arisen in the short time the tribunals have been operating.

Legal representatives who work with the tribunals have come in for considerable criticism, with one instance where a lawyer questioned whether a patient required counselling. Other criticisms include legal representatives not providing identification to healthcare workers to show who they were and some also giving very short notice to mental health institutions when they visit, while others are arriving at mental health facilities unannounced.

There have also been problems with documentation, including information on other patients being included in patient files. It is also understood that in one case a courier left confidential documents about a tribunal on a doorstep and in the wrong area. There is also a complaint that tribunal staff, on at least one occasion, took patient notes with them when they left an approved psychiatric centre following a tribunal hearing.

The timing of tribunals has also been causing problems with cancellations taking place because people were not aware that hearings were being rescheduled. Ward rounds have been cancelled and work loads were being rescheduled because of conflicting times being given for tribunal hearings. There have also been complaints that tribunals are interfering with service delivery.

Another example involved a consultant being told they did not have to attend the tribunal. As a result the chairperson of the tribunal was said to be unhappy with this and ordered a nurse to attend instead. The nurse, unprepared for the tribunal, could have still been cross-examined by that body.

Some tribunals are not being scheduled appropriately, with hearings taking place in separate locations on the same day and without travel time for personnel between psychiatric centres being taken into account. Tribunals are also meeting late in the evening, which, when they result in involuntary admissions being revoked, leads to complications if the patient has to be immediately discharged. In other instances, tribunal members are arriving at different times, causing delays.

Another contentious area is mental health reports on involuntarily detained patients, which are carried out for the tribunal by an independent psychiatrist. Consultants who are treating the patients in some mental health institutions are not being given the report on their patient before they enter the tribunal, while in some instances reports have been sent to the wrong place or do not arrive in time.