Government approves development of new Central Mental Hospital

16 May 2006

Mr Tim O'Malley TD, Minister of State with special responsibility for Mental Health, today (Tuesday, 16th May) confirmed that the Government has approved the development of a new Central Mental Hospital at Thornton, Co. Dublin. The new hospital is to be built on its own campus, adjacent to the planned Mountjoy Prison Replacement Complex. It will retain its identity as a separate, therapeutic health facility owned and managed by the Health Service Executive.

“This decision is a major step forward for the provision of quality care to prisoners with mental illness” the Minister said. “When I visited the Central Mental Hospital in Dundrum last year, I was taken aback by the fact that there has been little or no structural change to the main part of the hospital since it opened in 1850. Many elements of the building are reflective of the Dickensian era and this does not lend itself to the provision of a modern forensic mental health service.”

“I am very pleased that the Government has approved my proposal that Exchequer funding be provided for this important development, on the understanding that the State will recoup the costs involved when the existing site at Dundrum is sold. Any balance of funds remaining after the completion of the new hospital will be allocated to other capital developments within the health services, particularly in the community mental health services,” the Minister said. This approach to funding the development of capital infrastructure for the mental health services is in line with the proposals set out in A Vision for Change – the Report of the Expert Group on Mental Health Policy which was launched earlier this year.

The Government has also agreed that a new governance structure will be put in place for the Central Mental Hospital in advance of its move to the new site. It is proposed that a board of directors for the hospital be appointed by the Tánaiste & Minister for Health & Children, following consultation with the Health Service Executive and other relevant stakeholders.

The Central Mental Hospital is a national tertiary service and is the only centre in the State providing psychiatric treatment in conditions of maximum and medium security. The hospital provides acute psychiatric in-patient care to mentally disordered offenders, both sentenced and remand prisoners. Over 95% of its admissions are from within the prison service. The hospital also provides a range of services outside the hospital, including out-patient clinics and “in-reach” services in the prisons, assessment of tertiary referrals from local mental health services, community rehabilitation and occupational therapy programmes, and professional training at medical and nursing schools.

An analysis of recent trends in service delivery reveals a rise in the proportion of admissions with severe mental illnesses. This is predicted to continue and to increase substantially in the future. The Criminal Law (Insanity) Act, 2006 and the Government’s commitment to phase out the use of padded cells in prisons to hold mentally disordered offenders are likely to add to this pressure.

A project team will be appointed by the Health Service Executive shortly to progress the development of the new Central Mental Hospital. While the design specification will be a matter for this team to finalise, an Assessment of Need carried out in 2004 identified a requirement for 105 acute care beds and an additional 30 hostel places, to be located on the hospital campus.