Mental Health Commission publishes 2024 Annual Report
Improving national picture obscured by persistent high volumes of non-compliance in a small cohort of HSE inpatient centres
The Mental Health Commission has published its 2024 Annual Report which sets out its work to promote, encourage and foster the establishment and maintenance of high standards and good practices in the delivery of mental health services.
The report details how the organisation’s programmes of registration, inspection, monitoring and enforcement continued to improve inpatient mental health standards by holding providers to account. The publication of both national overview and individual centre inspection reports ensured a transparency for the public to clearly understand both the strengths and weaknesses of services.
Throughout 2024, the MHC continued to enhance its core objectives to drive standards, improve quality, and safeguard service users by working with all stakeholders. The report shows how the MHC engaged in several quality improvement initiatives across 2024, including the publication of the ‘Headspace Toolkit’ to provide an age-appropriate guide to children and adolescents receiving inpatient mental health care in Ireland; the ongoing development of standards for community mental health services; and the embedding of the National Quality Framework (NQF) in all services.
The report highlights many positive developments, including the steady and sustained decline in the use of restrictive practices, and a positive picture overall in terms of compliance in inpatient services, including examples that demonstrate how regulation and enforcement has ensured centres respond quickly and positively to poor inspection findings.
“The patient and service user are at the centre of our work, and when we identify non-compliances, our expectation is that the provider responds with specific, timebound actions to improve quality and safety,” said the Chief Executive of the Mental Health Commission, John Farrelly.
In his second report as Inspector of Mental Health Services, Professor Jim Lucey points to the fact that six approved centres achieved 100% compliance with the regulations, and highlighted several examples showing how a number of providers reversed poor levels of compliance and restored service delivery to a focus on quality improvement and good outcomes. He also welcomed the movement away from restrictive practices to a more rights-based approach across Ireland.
“The decline in the use of restrictive practices, including seclusion and physical restraint, represents one of the most notable human rights advances in mental health care in Ireland in recent times,” said Inspector Lucey. “These advances demonstrate how regulation can drive important human rights improvements and result in key behavioural change in the way services are delivered.”
However, the Inspector also reported that low compliance has persisted across several fundamental regulations such as individualised care planning, risk management, staffing and premises which, he said, are essential to delivering modern, person-centred care. In 2024, the number of non-compliances rated as high and critical increased on previous years, indicating concerning attitudes to compliance in a relatively small number of HSE services.
“In response to the inspector’s findings, the MHC was compelled to take 31 enforcement actions to safeguard service users and drive immediate improvements,” said Mr Farrelly. “These actions reflect our strengthened commitment to regulatory vigilance, but they also highlight deficiencies in a small number of HSE centres that must be addressed by the HSE leadership. Closer attention by the HSE to underperforming approved centres would transform the national picture.”
“Despite the difficulties in these centres, there are strong examples across the country of services delivering excellence. We continue to meet dedicated staff and clinicians committed to human-rights based and person-centred care. Their work is the foundation on which real, lasting change can be built.”
The report also details how the MHC operates as the custodian of the process for vindicating the rights of patients who are involuntarily detained in approved centres. It notes that 3,586 orders for a mental health tribunal were made in 2024, with 1,880 of these orders revoked before hearing, and 1,735 orders going to hearing. The tribunals team also provided voting rights information to voluntary and involuntary service users of mental health centres across the country to ensure they understood how they could vote during both the 2024 local and general elections.
The year 2024 marked the first full calendar year of operation for the Decision Support Service (DSS) and saw it successfully embrace and champion the principles of the Assisted Decision-Making (Capacity) Act 2015 - empowering people to make decisions about their lives in a manner that respects their will, preferences, and rights.
Mr Farrelly concluded: “Our 2024 annual report transparently sets out the work of the MHC including the first full calendar year of operation of the DSS. Together with services, staff, partners, stakeholders, and, most importantly, the people who use services and their families, we remain committed to a future where safe, rights-based and high-quality mental health and decision support services are a reality for all.”
To access the full report, please follow this link: The Mental Health Commission 2024 Annual Report
To view the annual report video, please follow this link: The Mental Health Commission 2024 Annual Report Video
