The Health Service Executive has responded to a new report which has criticised a number of practices at the Central Mental Hospital in Dublin.
The HSE has said it fully acknowledges the criticisms of some aspects of the report.
The executive says that, together with hospital management, it has already identified these problems and has begun bringing about the necessary improvements.
It says a team will immediately be put in place to review all the recommendations in the report.
The report, which was commissioned by the Mental Health Commission and follows an 18-month inquiry at the Dundrum facility, says the practices infringe patients' rights and dignity and impact on the standard of clinical care available to them.
It criticises the apparent overuse of seclusion on some wards in the hospital and says the hospital failed to ensure that seclusion was only used as a last resort.
It also criticises the method of seclusion in the female ward, and expresses concern about the use of automatic seclusion of new patients on the admission wards.
Locking patients in rooms criticised
The report's authors also express concern about a blanket policy of locking patients in their rooms at night, irrespective of risk.
They say patients are often kept waiting in a locked bedroom when needing to use the toilet since the practice of 'slopping out' ceased.
The report criticises the practice where all patients in certain units must go out for cigarette breaks, irrespective of whether they smoke or not.
It was also found that an absence of clear clinical leadership in wards has resulted in no clear line of accountability for standards of care in each ward.
The report accepts that buildings and long-standing organisational issues contribute to these unacceptable practices.
But it says the HSE must take responsibility for properly funding the service, providing adequate staff, and dealing with high-level industrial relations issues affecting clinical care.
HSE says changes are under way
The HSE says the report recognises patient satisfaction with the service, and says the satisfaction ratings are consistent with similar forensic facilities in the UK.
It says that since the inquiry team visited the facility, further progress has been made in a number of areas, including the introduction of a dedicated ward nurse management structure, providing clear lines of accountability in each unit.
The HSE says a Capital Development Project Team has been established to oversee the construction of a new, purpose-built facility, in line with the decision of government. This, it says, could be delivered within five years.
The HSE adds that it has invested an additional €4 million in revenue funding in the service since 2004, an increase of 28.9%.This year, a further €2 million is to be provided to address service priorities, with a capital investment programme of €2.3 million in place.
