Admission to a psychiatric hospital

If you are suffering from a mental disorder (see below), you may go into a psychiatric hospital or unit voluntarily, or you may be committed as an involuntary patient (against your will).

The vast majority of admissions to a psychiatric hospital are voluntary – this means that you freely agree to go for treatment.

The rules for admission to a psychiatric hospital

There are detailed rules about the involuntary detention of anybody in a public or private psychiatric hospital or unit. All psychiatric hospitals and units must be registered as approved psychiatric centres by the Mental Health Commission.

You can read more about the law on mental health in Ireland, your rights and how your best interests should be considered when you are receiving care for your mental health.

A mental disorder is defined as a mental illness, severe dementia or significant intellectual disability that you could be admitted to a psychiatric hospital involuntarily – against your will if:

• There is a serious risk that you may cause immediate and serious harm to yourself or to other people because of the illness, disability or dementia, and
• Your judgement is so impaired because of the severity of the illness, disability or dementia that your condition could get worse if:
  • You are not admitted to hospital for treatment that can only be given there, and
  • Going into hospital would improve your mental health significantly

Mental illness means a state of mind that affects your thinking, perceiving, emotion or judgment and that seriously impairs your mental function so that you require care or medical treatment in your own interest or in the interest of others.

Severe dementia means a deterioration of the brain that significantly impairs your intellectual function and affects thought, comprehension and memory and that includes severe psychiatric or behavioural symptoms such as physical aggression.

Significant intellectual disability means a state of arrested or incomplete development of the mind which includes significant impairment of intelligence and social functioning and abnormally aggressive or seriously irresponsible conduct.

Voluntary admission to a psychiatric hospital or unit happens in a similar way to admission to a general hospital.

You can be referred by your GP or consultant for admission to a psychiatric hospital.

Leaving a psychiatric hospital

Unlike patients in general hospitals, you are not always completely free to leave psychiatric care when you want to.

If you are a voluntary patient and want to leave a psychiatric centre and the consultant psychiatrist or a staff doctor or nurse considers that you are suffering from a mental health disorder, they may detain you for a maximum of 24 hours.

Decision after 24 hours

After 24 hours, the consultant psychiatrist must then discharge you or arrange for an examination by another consultant psychiatrist. The second consultant must issue a certificate stating that you should be detained because of a mental disorder or they must discharge you.

If you are detained, you are then an involuntary patient and all the procedures relating to information, review and appeal apply in the usual way.

You can read more on our webpage on the rights of psychiatric patients.

You may be admitted involuntarily – against your will – and detained in an approved psychiatric centre if you are suffering from a mental disorder (see above). This is allowed under the Mental Health Act 2001.

You cannot be admitted against your will purely because:

• You have a personality disorder, or
• You are socially deviant, or
• You are addicted to drugs or intoxicants.

There are 3 stages to admitting a person involuntarily to a psychiatric hospital:

1. Application for involuntary admission
2. Medical assessment
3. Psychiatric assessment

1. Application for involuntary admission

An application to admit a person against their will to a psychiatric unit can be made by a concerned person. They must be over 18 and must make the application to a registered medical practitioner (usually a GP).

The concerned person must have seen you in the past 48 hours and can be:

• Your spouse, or civil partner
• Your relative
• An authorised officer of the HSE who is authorised to make such a decision
• A Garda
• A concerned member of the public.

The following people cannot apply to have you admitted against your will: 

• Your separated spouse or civil partner, or

A person who is:

• Aged under 18
• Has an application or order against them under the Domestic Violence Act
• An authorised officer of the HSE or a Garda who is related to you or your spouse 
• A member of the governing body of the hospital (not including a staff member of the HSE)
• A person who works at the approved centre where you may be admitted
• A person who has a financial interest in the hospital where you may be admitted
• A medical practitioner providing regular medical service to the centre
• The spouse, parent, parent, grandparent, brother, sister, uncle or aunt of any of the above listed people. For example, the wife of a Garda that is related to you.

If the application is being made by 'any other person' (such as a member of the public), the application must state:

• The reasons for the application
• The relationship of the applicant to the person whose admission is proposed
• The circumstances in which the application is made.

What role could the Gardaí have?

A Garda can take you into custody if they have reasonable grounds for believing you are suffering from a mental disorder and there is a serious risk you may cause immediate and serious harm to yourself or another person.

The Garda may use force if necessary to enter the premises you are in. The Garda must then follow the normal procedure for involuntary admission. They must arrange for you to be examined by a doctor.

2. Medical assessment

When a doctor receives an application to admit you, they must examine you within 24 hours of receiving the application. The examining doctor cannot be a relative and cannot work for an approved centre.

The doctor must tell you the purpose of the examination unless they consider it would not be good for your mental health, well-being or emotional condition.

If the doctor thinks you are suffering from a mental disorder, they will recommend that you be admitted to hospital (an approved centre). This recommendation remains in force for 7 days.

If the doctor refuses the application and a subsequent application is made, the applicant must inform the doctor about the previous application, if aware of it.

Normally, you will be admitted to an approved psychiatric hospital.  You will only be moved to the Central Mental Hospital if a mental health tribunal approves it.

Getting to an approved psychiatric centre

Usually, the person who applies to admit you is responsible for taking you to the centre. If this is not possible, the doctor who recommended your admission can ask the clinical director of the centre or a consultant psychiatrist acting on their behalf to arrange for the centre's staff to bring you to the centre.

If necessary, the Gardaí may be asked to help. In this case, the Gardaí may enter by force the premises you are in. They may detain or restrain you if necessary.

3. Examination by a consultant psychiatrist

When you arrive as a patient at an approved psychiatric centre, you must be examined again by a consultant psychiatrist. You can be detained for up to 24 hours in the centre for this examination.

If the psychiatrist is not satisfied that you are suffering from a mental disorder, you must be released immediately.

Admission order to a psychiatric unit

If the psychiatrist is satisfied that you are suffering from a mental disorder, they will make an order for your admission.

The admission order is valid for 21 days. It authorises your reception, detention and treatment in the approved centre for this period.

Renewal order

A renewal order may extend your admission for a further 3 months. Your consultant psychiatrist must make the renewal order and they must have examined you in the week before making the order.

A mental health tribunal will review your case every time a renewal order is made.

A further renewal order may be made by the same psychiatrist for a further 6 months and after that, for 12 months at a time.

You can read more in our document on the rights of psychiatric patients.

Voluntary admission of a child

If a child is admitted voluntarily to a psychiatric unit by their parent or guardian, the medical professional can stop the child being removed if they consider the child is suffering from a mental disorder (see above).

Involuntary admission of a child

The HSE can apply for a child to be admitted involuntarily if the child is:

• Suffering from a mental disorder, and
• Needs treatment

The HSE must apply to the District Court. The court will order a psychiatric examination and may then make an order to admit the child to an approved centre for up to 21 days. The child's admission can be extended.

The court must give specific approval for any psycho-surgery or electro-convulsive therapy to be carried out on a child with a mental disorder.

You can read more about Mental health services for children and young people in Ireland.

The Mental Health Commission has a guide for young people accessing child and adolescent mental health services (CAMHS) in Ireland, Headspace Toolkit: Your guide as an inpatient.

You can read more in the guide to the Mental Health Act 2001. The guide explains your rights under mental health law.

How much does in-patient psychiatric care cost?

If you are ordinarily resident in Ireland, you are entitled to a range of public health services either free of charge or at reduced cost.

Your entitlement to in-patient services and the rules about hospital charges for psychiatric services are the same as for general hospitals.