Inspectors seek review of high use of sedatives in mental units

Irish Times
04.01.2011
By CARL O’BRIEN

MENTAL HEALTH inspectors have expressed concern over the high use of sedatives in psychiatric hospitals and have called for an “urgent review” of drug use in some facilities.

The inspector of Mental Health Services has found in some hospitals that as many as 80 per cent of long-term patients were being prescribed sedatives, also known as benzodiazepines.

Benzodiazepines are prescription drugs used to treat a range of conditions such as anxiety, insomnia and seizures. While they are considered safe for short-term use, the risk of overuse, abuse and dependence has been well documented.

Mental health campaigners also claim the drugs are being used to control the behaviour of vulnerable patients in the absence of access to activities, stimulation or therapeutic intervention.

Inspectors have been collecting detailed information on drug prescription patterns in mental health facilities for the first time. So far they have published reports for one-third of all mental health facilities inspected during 2010.

Of the 22 hospitals or care facilities visited, inspectors expressed concern over sedative use or called for an audit of drug-use in half of them.

Former inspector of mental hospitals Dr Dermot Walsh yesterday said he had long-standing concerns regarding the over-use of these drugs.

“The therapeutic misuse of benzodiazepines in medicine generally is a problem. These drugs are successful for short-term control of anxiety and so on, but should not be used in the medium or long term,” he said.

The inspectors’ reports so far show that benzodiazepines and night-time sedation is particularly high across a number of hospitals.

At St Joseph’s Hospital in Limerick, inspectors found 80 per cent of residents had a prescription for a benzodiazepine, many of whom were elderly. Over half were using them on a regular basis, prompting inspectors to recommend an “urgent review” of all drug use.

At An Coillin in Co Mayo, a 29-bed unit, inspectors found 78 per cent of patients on benzodiazepines, while 33 per cent were on more than one.

At St Edmundsbury Hospital, Co Dublin – a private facility – inspectors found high numbers of people on night sedation (82 per cent), as well as on benzodiazepines (73 per cent). Inspectors said these figures were “very high” and noted that medication sheets were of poor quality.

A previous report by the Mental Health Commission in 2009 raised concerns that patients at two psychiatric hospitals in Clonmel, Co Tipperary, were being inappropriately administered sedatives to control their behaviour.

It found a majority of residents at St Michael’s Unit, South Tipperary General Hospital, and St Luke’s Hospital, both in Clonmel, were receiving benzodiazepines on a long-term basis. This, inspectors said, appeared to be the result of a lack of activities and alternative treatment options.

The Mental Health Commission has declined to comment until it has published all of its inspection reports.

Full article

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