Mentally-ill patients are 11 times more likely to be involuntarily detained in a psychiatric hospital in Waterford than in Limerick, new figures show.
A census of psychiatric hospitals by the Mental Health Commission shows significant variations in the rate of patients being detained against their will in different parts of the country.
In general, around 2,000 patients - or 10 per cent of all admissions - are detained against their will in psychiatric hospitals. The areas of the country with the highest rates of detentions included Waterford (27 per 100,000 population), Kerry (24 per 100,000) and Longford-Westmeath (21 per 100,000).
The lowest rates were in Dublin southeast and Limerick (both two per 100,000 population) and Louth/Meath (three per 100,000).
Human rights campaigners say the figures indicate that patients in some parts of the country are being wrongfully detained due to factors such as less progressive approaches to mental healthcare or a lack of community-based care.
However, representative groups for consultants say the regional variations may be due to a range of factors, including the level of community services, bed availability and social or demographic factors in certain areas.
The census, conducted by the Mental Health Commission - the State's watchdog for standards in the sector - took place on November 8th last year, a week after the introduction of new safeguards aimed at protecting the rights of detained patients.
Experts say a week is too short a timeframe to draw any conclusions over the effectiveness of the new mental health tribunals, which automatically review the cases of all detained patients.
The census figures also provided a breakdown of the proportion of patients treated in individual catchment areas who were not resident in that area. This helps to give a more accurate indication of what impact regional services may have on involuntary detention rates.
For example, the rate of involuntary detention was highest in Dublin northwest (37 per 100,000 population). However, these figures appear to have been distorted by the location of a regional intensive care unit in the area, as a significant proportion (42 per cent) of patients were not resident in the area.
However, both Waterford and Kerry were not treating any patients from outside their catchment areas on the night of the census.
These detailed figures appear to challenge some consultants' claims that variations are due largely to demographic factors or the location of regional treatment units.
Overall, the Mental Health Commission is hopeful that detention rates in psychiatric hospitals will fall following the introduction of mental health tribunals.
Under the old system, governed by the Mental Treatment Act (1945), there were few protections for patients and no automatic periodic reviews of detention.
Under the new system, introduced on November 1st last year, if a person is detained in a psychiatric hospital, the Mental Health Commission must be notified within 24 hours.
The commission may appoint a solicitor or barrister to represent the patient, and an independent psychiatrist to visit and assess the patient.
Within 21 days of the detention, if the patient has not been discharged, a tribunal hearing should be held.
The three members of the tribunal include a legal expert, a consultant psychiatrist and a lay person. The tribunal can either affirm the detention or order the patient's discharge.
