The contribution of the Mental Health Commission in Ireland to the reform of mental health services

Published date30 November 2012
Date30 November 2012
AuthorLisa O' Farrell,Patricia Gilheaney,Rosemary Smyth
Subject MatterHealth & social care
The contribution of the Mental Health
Commission in Ireland to the reform of
mental health services
Lisa O’ Farrell, Patricia Gilheaney and Rosemary Smyth
Purpose – This paper aims to describe the establishment and evolution of Ireland’s Mental Health
Commission including its functions, strategic objectives and the challenges encountered.
Design/methodology/approach – This case study is based on an analysis of the outputs of the
organisation to date, legislative reviews, and available evidence on the contributionsof the organisation
to the development of services.
Findings – The organisation has a breadth of responsibilities. It has administered reviews of 9,896
involuntary admissions to inpatient units to date since its inception. It has regulatory and enforcement
powers in terms of the licensing of inpatient mental health facilities in Ireland. It has issued numerous
codes of practice and rules for the guidance of those working across services. It also has an
independent Inspectorate arm that inspects the quality of mental health services annually.
Research limitations/implications There is a risk of potential bias given the authors work for the
organisation, however, attempts have been madeto support observations with evidence fromexternal
Practical implications The organisation’swork has been seminal in enhancing the protection of the
human rights of persons accessing mental health services. Regulatory measures have also led to
changes in the behaviour of service providers, but it has proven to be more challenging to change
attitudes and culture within services.
Social implications The Commission has contributed to the reform agenda by focusing greater
attention on rights-based, participatory and recovery-oriented models of care provision.
Originality/value – This paper documents the work of the Mental Health Commission and highlights the
impact changes have had both for those using services and those providing them.
Keywords Mental health services, Oversight, Quality improvement, Regulation, Patient rights, Ireland,
Organizational structures
Paper type Case study
The Mental Health Act 2001 was published by the Irish Parliament on 8 July 2001. The first
commencement order was signed by the Minister for Health and Children enacting Sections
1-5, 7 and 31-55 from 5 April 2002. A second order was signed commencing the remaining
Sections of the Act from 1 November 2006. This paved the way for substantial changes to the
way mental health services were regulated in Ireland. The most notable development was
the establishment of an independent statutory body, the Mental Health Commission (MHC)
under Section 32 of the Act. This paper examines for the first time the breadth of functions
undertaken by the MHC since its inception including some of the challenges faced.
Evolution of the MHC
Many jurisdictions have in recent years established external agencies to monitor standardsof
care and drive improvements in mental health services. The MHC in Ireland was established
DOI 10.1108/13619321211289272 VOL. 17 NO. 4 2012, pp. 199-210, QEmerald Group Publishing Limited, ISSN 1361-9322
PAGE 199
Lisa O’ Farrell is Policy
Officer, Mental Health
Commission, Dublin,
Patricia Gilheaney is Chief
Executive, Mental Health
Commission, Dublin,
Rosemary Smyth is Director
Training & Development &
Interim Director Standards
& Quality Assurance,
Mental Health Commission,
Dublin, Ireland.

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