Ireland’s brand new Central Mental Hospital (CMH) is still grappling with serious safety and governance problems more than a year after an unprecedented inspection found widespread regulatory failures.
Internal records show that multiple issues identified during a 2024 inspection by the Mental Health Commission (MHC) remained unresolved midway through 2025.
This is despite the fact that the North Dublin campus opened just three years ago and was described by the then health minister Stephen Donnelly as “state-of-the-art” and a “major achievement”.
The MHC inspection found the hospital was compliant with just 51 per cent of the regulations examined and resulted in an Immediate Action Notice, a highly unusual step for a new-build facility.
In correspondence obtained under FOI, the hospital acknowledged the “stark findings” and said it was “very challenging and disappointing” to have fallen short of minimum standards.
They said extensive work had taken place but that a number of issues were still listed as “in progress” well into 2025.
These include procedures around patient admission, transfer and discharge, records management, the delivery of therapeutic services, and works to parts of the hospital building, including cracking floor surfaces.
The records also show that full compliance in some areas has been delayed by limitations in the hospital’s electronic systems, despite the facility being newly developed.
The CMH told the regulator that changes to its electronic health record system are required, but upgrades will not be complete until early 2026.
One of the most serious failures related to the monitoring of patients placed in seclusion.
Inspectors found that intercom systems used to communicate with patients were ineffective with staff describing them as “not fit for purpose.”
The hospital acknowledged that it was difficult to hear patients in distress unless the intercom system was actively engaged.
The documents show the hospital relied on interim safety measures while other solutions, including increased observation by staff, were explored.
One proposed solution was delayed amid concerns it would create ligature points in seclusion rooms that would create a risk of self-harm.
Later updates detail how acoustic improvements were eventually installed and tested, which had made it easier for staff to hear patients.
The correspondence also shows ongoing engagement with the regulator over whether the system, even with mitigations, met the required standard.
The hospital also told the regulator that recruitment delays had affected the delivery of therapeutic services, including psychology, with waiting times ranging from two weeks to six months.
Asked about the records, a spokesperson for the National Forensic Mental Health Service said they welcomed the work of the Mental Health Commission.
He said: “It is very challenging and disappointing that the CMH has fallen short of the expected minimum standards.
“We have put in place appropriate corrective and preventative actions to address the areas of non-compliance identified.
“The CMH is committed to improving regulatory compliance and has provided assurances and evidence of these undertakings to the MHC.”
He said the hospital had a committed, skilled, and caring workforce but acknowledged that the demands on staff, systems and processes during “an extended and not yet complete time of change” had been substantial.