Covid-19 paper recommends urgent investment in mental health facilities10 June 2021
We have recommended urgent investment in mental health facilities and the development of more robust legislation to ensure that buildings are fit for purpose and meet best practice in terms of infection, prevention and control standards in the event of further surges of COVID-19 or future pandemics.
The recommendation forms part of second review paper published this morning by the MHC that examines the impacts and response to COVID-19 in residential mental health services and seeks to share findings to help ensure residents and staff are protected from future infection risks.
Over the course of the past year, the MHC has gathered significant data, information, and trends as part of its work to monitor and support 184 mental health services to manage and mitigate the virus. Combined, these facilities care for approximately 3,900 service users across the country.
The paper also highlights the steps taken by the MHC to support services and to ensure that residents were safe and that their rights were upheld while the pandemic was ongoing.
“The purpose of our paper is to first and foremost share learnings and developments to reflect the quality of work undertaken in mental health services during the pandemic,” said the Chief Executive of the Mental Health Commission, John Farrelly. “It is also critical we do so to ensure that services are as well prepared as possible for any further surges of COVID-19 or, indeed, future pandemics.
“The weaknesses around premises as outlined in this paper won’t come as a surprise to anyone who has been reading our inspection reports over the past number of years. One of our key recommendations in this paper is increased investment and targeted regulations to ensure all residential and inpatient mental health services are in modern, fit-for-purpose buildings, which comply with infection prevention and control standards. A more targeted regulatory framework will help to ensure that residents are provided with the surroundings and premises that will create dignity and hope while protecting against the risk of future infection.”
As the paper notes, mental health service users that are resident in acute settings and long-term residential care units may be particularly susceptible to developing COVID-19 for a number of reasons. These include the fact that many services are still located in multi-occupancy, outdated buildings, and individuals receiving care and treatment for mental health issues may be less able to readily comply with infection, prevention, and control guidelines.
Staff in mental health services played a critical role in protecting residents from the risk of acquiring COVID-19. The findings also show that frontline staff bore a significant burden of the disease. Staff in the residential services, which were monitored by the MHC, were at higher risk of contracting the disease then residents. A detailed analysis of 422 confirmed cases of COVID-19 which were reported between March and July 2020 was undertaken to understand how cases were distributed amongst staff and residents. Of the total confirmed cases, 64% were staff members, with residents accounting for the remaining 36%. Of the staff affected, the grouping most affected were nursing staff, who accounted for 55% of the mental health staff members who acquired COVID-19. The paper highlights the high levels of knowledge and expertise demonstrated by staff regarding infection, prevention and control practices and commends their work in this area.
However, the guidance available to staff during the pandemic was not always tailored to the residential mental health services. In order to ensure that staff and residents are better protected, the MHC recommends that national guidance should be proofed at the outset to ensure its relevance to all mental health service types and to ensure that there is parity between mental health and physical health services.
Other recommendations include the retention of MHC-implemented collaboration, reporting and escalation protocols with the HSE and the Department of Health to ensure that relevant risks to residents are mitigated in a timely manner; that staff training in emerging infection prevention and control best practice should continue to be prioritised to help prevent and manage future outbreaks; and that mental health services should be considered in parallel to physical health services in relation to all future vaccination plans.
“The COVID-19 pandemic has required residential mental health services to respond and adapt to a rapidly evolving risk environment on an unprecedented scale,” said the Director of Regulation for the Mental Health Commission, Gary Kiernan. “From the outset of the pandemic, services have shown a capacity for change and resilience which helped them in the prevention and treatment of COVID-19. The response and actions taken by services has not only ensured that service delivery has been sustained but has also prevented the spread of illness and saved lives.
“In compiling the paper, we learned of numerous examples of how staff in mental health services worked extremely hard to support and protect residents who have been impacted by the pandemic. It is also evident from our findings that frontline staff in mental health services accounted for a considerable number of COVID-19 cases. The MHC wishes to acknowledge the sacrifices and tireless work of frontline staff in protecting residents.”
The report also includes references to some innovative practices introduced by services in response to COVID-19. Responses demonstrated the implementation of a variety of new practices, particularly in the areas of resident wellbeing, information sharing and advancements in service use of technology.
You can read our full statement here.
You can download the full report here.