Risk Management In Mental Health Services Page 52
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54response is required to mange the issue. It is designed to allow the HSE as a
whole organisation to learn from Serious Incidents.
Within the Mental Health services there are a number of adverse event
reporting requirements to statutory agencies and external bodies such as the
Mental Health Commission (MHC, which requires 6-monthly incident summary
reports), The Health and Safety Authority, the Clinical Indemnity Scheme, Irish
Public Bodies and other Public Liability and Clinical Liability Indemnifiers.
There is also a requirement for An Garda Síochána to complete a confidential
Form 104 which is sent to the Central Statistics Office (CSO) after a coroner’s
inquest has taken place. This captures information relating to whether the
death was accidental, suicidal, homicidal or undetermined. The data recorded
on this form was recently analysed by the National Suicide Research
Foundation following which a number of recommendations were made, notably
that another system be developed to collect data on the medical and
psychosocial characteristics of individuals whose deaths lead to inquests, such
as introduction of national inquiries as is performed in other countries.
The National Registry of Deliberate Self harm was established by the National
Suicide Research Foundation in 2002. This monitors presentations following
deliberate self harm to A/E Departments in all general hospitals in Ireland.
The MHC has developed a Code of Practice for notification of deaths and
incident reporting requirements to the MHC, which is applicable to approved
centres, day hospitals, day centres and 24 hour staffed residences within
mental health services.
The State Claims Agency introduced a national secure web based incident
reporting system in 2003, called STA RS Web for use by enterprises
participating in the Clinical Indemnity Scheme for notification of clinical
incidents. This system links public hospitals and other healthcare enterprises
to a national database where they can access their own data on their reported
incidents. The data from this system can be utilised to provide the incident data
summary reports required by the Mental Health Commission.
There were 7812 clinical incidents reported to the Clinical Indemnity Scheme
from public Mental Health Services in 2008. The breakdown of the top 5 event
types reported is presented in Figure A.2. The highest (35.5%) event type
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reported relates to the category of violence, harassment and aggression
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