Nearly half of inpatient mental health centres breached drug rules in 2025, reports shows

Darragh Mc Donagh

The Mental Health Commission (MHC) has expressed concern after nearly half of the country’s inpatient mental health facilities were found to be in breach of regulations governing the use of psychotropic drugs last year.

Unannounced inspections of 67 registered centres during 2025 found that just 36 were fully compliant with regulations setting minimum standards for the safe ordering, prescribing, storing and administration of drugs.

The compliance rate of 53.7 per cent represents a steep drop from the previous three years, when compliance levels hovered between 73 per cent and 77.3 per cent, according to a newly published report by the MHC.

The slump followed an update to the Judgement Support Framework by the MHC, strengthening requirements for the introduction of tracking on items for High-Dose Antipsychotic Treatments (HDAT).

The annual inspections and review were introduced by the MHC following concerns that a dramatic reduction of nearly 50 per cent in the number of physical restraint and seclusion incidents in recent years may be associated with increased reliance on tranquilisers and other drugs.

In the latest report, the Office of the Inspector of Mental Health Services defended the standard of daily care at approved centres but expressed concern over the core inspection outcomes.

“The 2025 inspection finding of 53.7% overall compliance with Regulation 23 is of concern, but these data need to be seen in their clinical context,” it said.

“Administration of prescribed medication throughout approved centres involves very large numbers of prescription to resident administrations. The vast majority of these are appropriate, safe and uneventful.”

In response to the sharp drop in compliance, the inspector has advised the MHC to enforce mandatory revisions for 2026, making a full policy suite, internal medication safety audits, and quarterly oversight committee access minimum requirements for all registered proprietors.

The regulator has also confirmed it will take steps to establish a specific code of practice regarding the use of rapid tranquilisation in approved centres to safeguard residents’ human rights.

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