Overview of Mental Health Services

There are also other types of mental health services, for example, day hospitals and 24-hour nurse-staffed community residences. 

In this section we will cover:

• what an approved centre is
• what types of approved centre there are
• what does it mean to be a resident in an approved centre
• other types of mental health services available
• how the MHC inspects and regulates mental health services

What is an approved centre?

Section 62 of the Mental Health Act 2001 defines an approved centre as, a hospital or other inpatient unit that is led by a consultant psychiatrist and whose primary role is the care and treatment of people with a mental illness or disorder. Under sections 63 and 64 of the Act, every inpatient mental health unit in Ireland must be registered with the MHC as an approved centre. The centre must meet certain requirements before the MHC can add it to the Register of Approved Centres. A centre may only operate if it is registered.

Different types of approved centre

There are various types of approved centre providing different services, including: 

• general adult mental health services
• child and adolescent mental health services, commonly referred to as CAMHS
• forensic psychiatry services
• intellectual disability services

As the name suggests, general adult mental health services care for and treat people aged 18 or older who present with a mental illness or disorder. 

Child and adolescent mental health services assess and treat young people experiencing mental health difficulties and their families. A number of services support children and adolescents, but the name ‘CAMHS’ is usually given to services that provide specialist mental health care and treatment to young people up to 18 years through a multidisciplinary team.

Forensic psychiatry services assess and treat people with mental disorders who show antisocial or violent behaviour. A key element of this service is the link between mental health and the law. The service provides expert evidence in the civil and criminal courts, and assessment and treatment of offenders with mental disorders and other patients with mental disorders who have not committed an offence. 

Intellectual disability services care and treat people with both a mental health diagnosis and an intellectual disability. 

The approved centres offer different services including:

• psychiatry of later life services for older people
• long-stay services
• rehabilitation services
• addiction services such as for eating disorders

While the HSE operates most approved centres in the country but some are privately run. The Register of Approved Centres can be found at the Approved Centres section on our website.

What does it mean to be a resident?

A resident is someone who has been admitted to an approved centre and is receiving treatment there. When being admitted, residents are given information about the approved centre and its services. Residents work with the multidisciplinary care team to develop a care plan for their treatment. 

Under the Mental Health Act 2001, the best interests  of residents in an approved centre must be considered before any decision about their care and treatment is made. Residents have a broad range of rights while in an approved centre, including:

• the right to be treated with dignity and respect
• the right to be listened to by all those working on their care team
• the right to take part in decisions that affect their health
• the right to be fully informed about their legal rights, admission and treatment

How does the MHC regulate approved centres?

The MHC works to fulfill its main functions under the legislation through the registration and inspection of approved centres. Section 51(1)(a) of the Mental Health Act 2001 (the 2001 Act) states that the main function of the Inspector shall be to 

“visit and inspect every approved centre at least once a year in which the commencement of this section falls and to visit and inspect any other premises where mental health services are being provided as he or she thinks appropriate”.

At least once a year, the Inspector assesses every approved centre under all regulations, Rules, Codes of Practice, and Part 4 of the 2001 Act. Inspectors review documents, observe, and carry out interviews to assess whether the centre complies with the requirements. Where the Inspector decides a centre does not comply, they assess the risk level of the non-compliance. The Inspector and Assistant Inspectors also assess the quality of services against the Judgement Support Framework. 

You can read more on the section Judgement Support Framework on the website.

Following inspection, the Inspector and Assistant Inspectors write a report on their findings. They give a draft to the registered owner of the approved centre. The draft includes provisional compliance ratings, risk ratings and quality assessments. Areas of inspection are judged either compliant or non-compliant. Where there is non-compliance, risk is rated as low, moderate, high or critical. 

All published inspection reports are in the section Approved Centres on our website.

The registered proprietor can review the draft report and comment the content or findings. The Inspector takes account of the comments of the registered proprietor and amends the report as appropriate. The Inspector asks the registered proprietor to provide a Corrective and Preventative Action (CAPA) plan for each non-compliance.

Corrective actions address a specific non-compliance. Preventative actions reduce the risk of the non-compliance happening again. CAPAs must be specific, measurable, achievable, realistic, and time-bound (SMART). The final inspection report includes the approved centre’s CAPAs. The MHC monitors how the CAPAs are being carried out and asks for further information and action. If we decide the CAPA plan is not acceptable, we may take enforcement action.

Other types of mental health services

A wide range of other community mental health services are available, along with approved centres. Community mental health services include:

• 24-hour nurse-led residences
• general adult community mental health teams
• Child and Adolescent Mental Health Services teams
• specialist teams
• day hospitals and centres
• home based treatment teams
• medium or low support residences

Currently, the MHC inspects only the 24-hour nurse-led residences. We inspect them every three years through reviewing documents, observing, and holding interviews, similar to how we inspect approved centres.