Irish Mental Health Act 2001: impact on involuntary admissions in a community mental health service in Dublin

Izu Nwachukwu,Niall Crumlish,Elizabeth A Heron,Michael Gill

doi:10.1192/pb.bp.109.028043

Izu Nwachukwu, Niall Crumlish + Show 2 more

Open Access

https://doi.org/10.1192/pb.bp.109.028043

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Abstract

Aims and methodOn 1 November 2006, Ireland's Mental Health Act 2001 was implemented, replacing the country's Mental Treatment Act 1945. We aimed to assess the impact of this change in legislation on the number and duration of involuntary admissions. We undertook a retrospective review of all admissions to a psychiatric admissions unit from January to October 2006 (pre-implementation) and January to October 2007 (post-implementation).ResultsThere were 46 involuntary admissions in the 10-month period under study in 2006, or 33.8 per 100 000 population. There were 53 in 2007, or 39.3 per 100 000 population. This increase was not significant (z = – 0.7, P = 0.46), however involuntary admissions formed a larger proportion of all admissions under the Mental Health Act 2001 than under the Mental Treatment Act 1945 (χ2 = 4.2, P =0.04). There was no difference in the duration of involuntary admissions but under the 2001 Act, involuntary patients had longer periods of voluntary status as part of their admissions than under the 1945 Act.Clinical implicationsThe introduction of more rigorous procedures for involuntary admission did not significantly change the rate or duration of involuntary admissions in our centre. The finding that involuntary admissions included longer periods of voluntary status suggests that more care is being taken to revoke involuntary admission orders under the Mental Health Act 2001 than under the Mental Treatment Act 1945.

Highlights

We set out to assess the impact of the introduction of the Mental Health Act 2001 on admissions into the psychiatric unit in the Jonathan Swift Clinic in St James’s Hospital, a designated approved centre in south inner-city Dublin
We hypothesised that there would be fewer involuntary admissions under the Mental Health Act 2001 than under the less rigorous Mental Treatment Act 1945, and that involuntary admissions would be shorter under the new Act than under the old Act
Our findings indicate that the introduction of the Mental Health Act made no difference to the rate of involuntary admissions

Summary

Results

There were 770 admissions during the study period. In total, 671 admissions (87.1%) were voluntary and 99 (12.9%) were involuntary. = 41.6, median = 32.0, range 1-168) and the mean duration of all admissions that included an involuntary period was 52.1 days In 2006 the total catchment area population was 136 000 and the number of involuntary admissions for the 10-month study period was 46, so that the rate of involuntary admissions was 33.8 per 100 000 population. There was no difference between 2006 and 2007 with respect to the mean duration of admissions including an involuntary period We determined whether the difference in duration of voluntary status during involuntary admissions was because individuals under the new Act were more likely to be admitted voluntarily and detained later in the admission, or because they were more likely to have initial involuntary status re-graded to voluntary before discharge.

Method

Discussion

Limitations and external validity