New Central Mental Hospital still battling serious failings long after watchdog intervention

Ireland’s Central Mental Hospital (CMH), opened in north Dublin just three years ago and promoted as a flagship, state-of-the-art forensic facility, is continuing to struggle with serious safety and governance failures more than a year after formal intervention by the Mental Health Commission.

Records released under Freedom of Information show that a 2024 inspection found the hospital compliant with only about half of the regulatory standards reviewed — a startling outcome for a newly built national facility.

The findings were so severe that the regulator issued an Immediate Action Notice, a rarely used enforcement measure reserved for high-risk situations. Internal correspondence indicates that many of the problems identified during that inspection were still unresolved well into mid-2025, with key areas repeatedly marked as “in progress”.

Among the outstanding issues were weaknesses in patient admission, transfer and discharge procedures, failures in records management systems, delays in the delivery of therapeutic services, and physical defects within the building itself, including cracked flooring.

The documents also show that limitations in the hospital’s electronic health-record systems contributed to delays in achieving full compliance, with some system upgrades not expected to be completed until early 2026.

One of the most serious failings related to the monitoring of patients placed in seclusion. Inspectors found that the intercom system used to communicate with isolated patients was ineffective, with staff describing it as “not fit for purpose”. In some cases, patients in distress could not be clearly heard unless the system was already actively engaged.

While interim safety measures were introduced, including increased physical observation by staff, at least one proposed technical solution was postponed after concerns it might introduce new ligature risks in seclusion rooms.

Later correspondence shows that acoustic improvements were eventually installed and tested, improving staff’s ability to hear patients, although discussions continued with the regulator about whether the system now met required safety standards.

Recruitment delays were also blamed for long waiting times for therapeutic supports, including psychology services, with some patients waiting months to access care.

A spokesperson for the National Forensic Mental Health Service acknowledged the shortcomings and said corrective and preventative actions were being implemented, noting the pressure placed on staff and systems during a prolonged period of structural change.