Call for more monitoring of psychiatric patients

Seriously mentally ill patients should be re-admitted into care if they do not attend for treatment or take their medication, the annual conference of psychiatric nurses has been told.

Families and communities are entitled to assurances that unnecessary risks are not being taken with their safety because of the actions of a very small number of mentally ill people, Des Kavanagh, general secretary of the Psychiatric Nurses' Association told the conference.

Mr Kavanagh said violence was not synonymous with mental illness and the vast majority of patients were “lovely, sensitive people who pose no threat to the community”.

“However, we must honestly acknowledge that a very small number do present a threat and sometimes a very serious threat to family, staff and indeed to complete strangers.”

In recent years, he said, these have included: “deaths by murder” of patients in psychiatric units; deaths of family members murdered by people known to the services who often then take their own lives; assaults by people who have stopped taking their medication; and murders by people who were declare not to be mentally ill but subsequently become involved in crime.

Mr Kavanagh said no-one wanted to return to the days of preventative incarceration but the right of a person to liberty was not unfettered. “The question is: How do we balance the rights of the seriously mentally ill person against the rights of the family and the community?”

The association has recommended the use of community supervision order to ensure discharged patients were compliant with their treatment regime. However, the use of supervision orders was rejected and no alternative put in place.

Threat to family

“It is not acceptable that a person who because of their illness poses a threat to their family or community can maintain the right to liberty, the right to choose not to take their medication irrespective of the implications.”

Mr Kavanagh said mental hospitals which provided asylum for people with enduring mental illness have been closed down as unsuitable, only to be replaced with prisons. “This is a scandal not just for the seriously mentally ill. The impact on families is a far greater scandal as we regularly come across cases of parents, partners and children being killed by their seriously mentally ill family member.”

He challenged Minister of State for Mental Health Kathleen Lynch to "get out of the comfort zone" of talking about "soft" issues by making a real difference to the world of the seriously mentally ill.

He claimed there was no focussed strategy for investigating all adverse events, and no sharing of or learning from the learning acquired.

An independent review of the Government’s “Vision for Change” mental health strategy was needed to assess how much has been implemented since 2006, he told the conference in Athlone.

Mr Kavanagh also called for an independent investigation into the acute unit at University Hospital Galway, which he said has suffered 34 assaults on staff in the first three months of this year.