An audit of Mt Carmel Hospital had slammed practically every aspect of its operations, saying it is under-funded, poorly staffed, with poor relations between management and staff, and inadequate security.
The audit was carried out by the Auditor-General and presented to parliament on Wednesday.
The Audit Office said Mt Carmel Hospital's current unacceptable condition was the result of the long-standing legacy of the government’s lack of commitment towards mental health.
"This audit has shown that Mount Carmel Hospital, and by implication mental health in Malta, are still considered a second priority to the rest of the local public health sector," the office said.
It welcomed a pledge by the government to invest some €30 million on much needed structural repairs at Mt Carmel but insisted that those repairs, on their own, would not solve the hospital's shortcomings.
Progress could only be achieved if this investment was accompanied by an improvement in the hospital’s recurrent financial allocation and an overhaul in the way it operated.
"Apart from a pronounced shortage of human resources, particularly in the nursing grades, this office also observed that relations between the hospital’s management and its staff are generally strained, which situation heavily impinges on the efficiency and effectiveness of the hospital’s operations," the Audit Office said.
It added that security arrangements were largely inadequate, with the security staff not carrying out security functions involving the physical element (such as searches or restraint). There was poor monitoring of the hospital’s master keys.
It even found that some security functions were carried out by nursing staff.
Security at the hospital’s main gate was found to be lax, while the CCTV system 'leaves much to be desired'.
The study also found that Mount Carmel Hospital is serving as a place of last resort for a significant number of people who, though possibly in need of assistance, do not require hospitalisation in a mental health institution.
"This situation is putting further strain on the already stretched resources, and consequently, on the level of service offered to the mental health patients who do require hospitalisation."
It said that a comprehensive national strategy for mental health needs to be given priority.
"This initiative should ensure the effective overhaul of Mount Carmel Hospital and mitigate the prevalent negative stigma on mental health. In this regard, this Office feels it cannot emphasise enough the importance of having community services at the centre of any mental health strategy, as a strong community based system would ensure that hospitalisation in a mental health institution would become only a requirement for the most clinically acute cases. By implication, such a system would serve as a pressure valve for Mt Carmel Hospital and significantly reduce the impact on the national health bill, while ascertaining that, when possible, mental health patients remain integrated within the community and valuable contributors to society," it said.
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