Illicit drug use at mental hospital

[Posted: Fri 22/05/2009 by Niall Hunter, Editor www.irishhealth.com]

The HSE says it is taking action to control illicit drug abuse by patients at St Ita's Psychiatric Hospital in north Dublin.

It was responding to a report from the Inspector of Mental Health Services that service users at the hospitals had made complaints about illicit drug use on the acute wards by other patients at the hospital.

A leading psychiatrist has told irishhealth.com that there is a small but persistent amount of illicit drug-use in mental healthcare institutions in Ireland.

Dr Siobhan Barry of the College of Psychiatry of Ireland said there should be a routine and accurate urinalysis  testing system for drug use in mental healthcare centres thoughout the country.

The HSE told irishhealth.com that the occurrence of alcohol and drug abuse at St Ita's would be small in number relative to overall activity at the hospital.

It said a liaison service was being developed with the Gardai in Swords to assist it in tackling illicit drug use in the hospital "and other challenging situations."

The latest Inspector of Mental Health Services report had stated that a small number of service users at the hospital had expressed concern about the presence of illegal drugs on its acute wards.

The HSE said it has a protocol in place to manage alcohol and illicit drug abuse in the acute units at St Ita's.

"If a patient is suspected of taking illicit drugs or alcohol, a random urinalysis is undertaken for screening purposes. The patient is reviewed by the doctor on duty and may be discharged and/or referred to the A&E department at Beaumont Hospital for further screening."

The HSE said if a patient has a dual diagnosis, that is psychiatric diagnosis plus drug misuse problems, it is not always possible to discharge the patient as they may be a risk to themselves or others.

Dr Barry said, however, that urinalysis drug screening should be part of the routine assessment at point of admission to a psychiatric facility. She said such routine screening was not implemented everywhere at present.

She said dipstick analysis can be done on wards, but this testing was not as accurate, and more accurate and rapid testing would be preferable.

She said ideally, urine tests should be sent to a laboratory for analysis, and accurate drug screening can improve the accuracy of a patient's diagnosis.

The Inspector's report criticised facilities at St Ita's as being unsuitable for patients and required considerable capital funding to bring it to an acceptable standard.

St Ita's has been earmarked for closure for many years, but this has been held up due to a long delay in building a new in-patient psychiatric unit at Beaumont Hospital.