Report expresses concerns about physical restraint at Galway Mental Health Unit

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A report from the Mental Health Commission raised concerns about the physical restraint of patients at a Mental Health Unit in Galway.

The 50 bed mental health unit at University Hospital Galway was inspected by the Commission last November, and the results were released this week.

The report found the centre had four areas classified as “high-risk” where it was not compliant with regulations: the use of physical restraint, staffing, register of residents, and admission, transfer and discharge.

In two of the incidents of physical restraint noted in the report the patients were not told why they were being restrained, for how long, or why the restraint ended.

Two episodes were highlighted in the report where the patients’ representatives were not informed abut the physical restraint and the reasons for not telling them were not recorded.

The report also said that in two cases “there was no record to indicate that the resident had received a medical exam at all by a registered medical practitioner within three hours after the start of an episode of physical restraint.”

“In one case, while a medical exam did take place, there was no time record to show that it took place within three hours after the start of the physical restraint episodes.”

And in all three of the instances noted in the report there was no record to indicate that the episode had been reviewed by a multi-disciplinary team within two days.

Dr Susan Finnerty, Inspector of Mental Health Services, said that according to the Commission’s Code of Conduct “staff should only use physical restraint when no other option will work”.

“A patient can only be restrained for a maximum of thirty minutes at first, after which a doctor must review.”

“The doctor may decide that further restraint is necessary and at this stage they must make a renewal order that allows the patient to be restrained for up to another thirty minutes.”

She added that being restrained is a very serious action and if a patient is restrained the staff must tell them why, how long it will last, and what needs to happen to make it end.

Staff will end physical restraint “when a doctor or nurse decides that the patient is no longer a serious threat to themselves or others.”

Other issues raised in the report included a lack of timely information given to a patient’s GP after their discharge and.

In one instance a discharge summary was not sent to the GP for 23 days , well outside of the 14 day requirement.

The summary did not include details of their prognosis, nor was a timely follow up appointment arranged.

Overall the report said that the mental health unit at UHG was compliant with 81 percent of regulations and was rated as excellent in nine areas.