A long way to go before services are equitable. Summary of countrywide supervision in 2017-2018 of hospital services for people with a mental health disorder and a possible concurrent addiction disorder

Do people with a mental health disorder and possible concurrent addiction disorder receive comprehensive, individually adapted and adequate out-patient treatment from the mental health services? Are patients given the opportunity to participate in deciding on the services they receive? The Offices of the County Governors found breaches of the legislation and inadequacies in 18 of 20 out-patient clinics in community mental health care centres that they investigated.

Inadequate investigation and examination of patients was one of the main findings from supervision. Investigation and follow-up of possible addiction problems and somatic health disorders was also an area that was often inadequate. The result can be that patients’ disorders and the challenges they experience in their lives, in addition to their mental health disorder, are not identified, and that their treatment is not comprehensive or adapted to their needs.

The skills of the clinicians were often not adequately assessed. Clinicians’ established practice and training were often inadequate to ensure that they had the skills that were required.

Serious deficiencies in leadership resulted in arbitrary practice. It was often left up to the individual clinician to assess what was good enough.

In health trusts where services were inadequate, there was a lack of reporting systems and control procedures for identifying problem areas and for initiating necessary corrective measures.

The results of supervision show that there was much that needed to be improved and followed up in order to ensure that patients were well looked after and received effective and equitable services.