Mental Health Commission states urgent action is required to prepare for potential second wave of Covid-19 in mental health services | Fieldfisher
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Mental Health Commission states urgent action is required to prepare for potential second wave of Covid-19 in mental health services

Hannah Unger



On 14 July 2020, the CEO of the Mental Health Commission (the "Commission"), Mr John Farrelly addressed the Oireachtas Special Committee on Covid-19 (the "Committee"). The Mental Health Commission is an independent statutory body whose primary functions are to foster and promote high standards of care and good practice in the delivery of mental health services and to ensure that the interests of those involuntarily admitted are protected, pursuant to the Mental Health Act 2001.
The following is of note of Mr Farrelly's address to the Committee:

  • Mr Farrelly stated that actions need to be taken now to ensure that mental health services are better equipped to deal with Covid-19 and the possible second wave of infection.
  • On 1 April 2020 the National Public Health Emergency Team (NPHET) tasked the Commission with monitoring and risk-rating approved mental health centres and long term community settings. Mr Farrelly said that the Commission identified a number of concerns as part of their risk-rating of mental health facilities over the past three months and that urgent steps must now be taken. Mr Farrelly stated that issues of concern include:
  1. the lack of specific public health guidance for mental health settings;
  2. significant delays and inconsistencies in testing;
  3. inconsistency in the continuity of services; and
  4. the suspension of community-based services.

However, Mr Farrelly stated that the primary concern related to facilities with shared accommodation and their limited ability to isolate service users or promote social distancing. In this regard, Mr Farrelly commented as follows:

“This pandemic has brought into sharp focus the fundamental shortcomings in accommodation for mental health facilities. Covid-19 has highlighted the significant risks associated with shared, and in particular, dormitory-style accommodation. For years, the Commission has also been sounding the alarm on other critical deficiencies such as structural safety, lack of privacy, and premises that are dirty and in disrepair.

 It is critical that there now must be a national review of shared accommodation without delay. We must see regional and national governance and oversight of contingency plans to address accommodation that is not compliant with Infection Prevention and Control (IPC) standards, while ensuring the assessed needs of service users are being met.”
  • In order to continue the Commission's fight against widespread outbreaks, Mr Farrelly recommended that:
  1. there are clearly defined points of contact and shared protocols for each facility in relation to testing, contact tracing and PPE;
  2. clear public health guidance specific to mental health settings, including clear criteria for the suspension and resumption of services; and
  3. data driven systems analysis of Covid-19 progression within mental health services.
  • Mr Farrelly said that there are also long term actions that need to be commenced now, to ensure the system is prepared for a future pandemic or equivalent crisis and commented as follow:

“There must be commitment to proper investment to the full spectrum of community mental health services as set out in new Government policy ‘Sharing the Vision’ to reduce reliance on acute inpatient services and to allow people to be cared for and  supported to live in the community where possible.” . 

“It is essential also that there is similar commitment to provide modern, therapeutic and safe environments in which mental health services are provided, which promote recovery and respect the privacy and dignity of the person.”
  • Despite the significant challenges, only 31% (56) of all mental health services monitored reported confirmed cases of Covid-19 among staff and/or service users. There was also a very small number of services with widespread outbreaks. This was largely due to the Commission's role in monitoring and risk-rating approved mental health centres, which included:
  1. requesting that all approved mental health centres notify the Commission as soon as they became aware of any confirmed or suspected cases of COVID-19, and requested to be shown all contingency plans that they had in place.
  2. monitoring centres on a regular basis to ensure plans were adequate and appropriate based on disease progression, environment and staff; and
  3. liaising with HSE national and regional governance structures to deliver mitigating actions.

The press release published on the Mental Health Commission's website in relation to Mr Farrelly's address to the Committee can be accessed here.
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