In early September 2026, the Mental Health Commission (MHC) of Ireland published a new Code and Guidance document regarding the use of vision-based monitoring (surveillance) technologies within mental health inpatient settings. It covers CCTV, body-worn cameras, infrared cameras, sensors and GPS tracking devices. Published jointly with the Data Protection Commission, the code follows recognition that new and emerging digital technologies are being introduced internationally, and that existing regulation must adapt to address the changing technological landscape of healthcare provision and the proliferation of AI.
The Mental Health Commission is an independent statutory body in Ireland established under the Mental Health Act (2001) to regulate and inspect mental health services in Ireland and facilitate mental health tribunals. It holds statutory powers to ensure healthcare compliance, akin to the roles of the CQC and NHS England. Services providing inpatient psychiatric treatment within Ireland must be registered as Approved Centres with the MHC. The Data Protection Commission is the Irish supervisory authority for the General Data Protection Regulation (GDPR), similar to the UK’s Information Commissioner’s Office (ICO).
As outlined by the MHC, the MHC/DPC Code and Guidance (henceforth the Code), adherence to which will be monitored:
“…establishes a comprehensive regulatory framework governing the use of digital monitoring technologies in approved mental health centres […] It places a strong emphasis on human rights-based, trauma-informed and person-centred approaches, requiring mental health services to carefully balance safety and care considerations with a person’s rights to privacy, dignity, bodily integrity and autonomy.”
The Code was developed following extensive engagement with stakeholders – including service users, family, staff, healthcare organisations and Disabled People’s Organisations. It was also informed by an in-depth review of the evidence-base for the use of a broad range of surveillance and vision-based monitoring technologies, including academic and grey literature, as well as international guidance and regulations, in particular the UK standards and guidance. Compliance with the Code, which comes into force from 1 January 2027, is not optional and will form part of inspections and adherence will be regulated by the statutory agencies. The Code is published alongside the Data Protection Commission’s new guidance on the use of CCTV within residential care settings which outlines that “CCTV generally should not be installed in areas where individuals would reasonably expect a higher degree of privacy, such as bedrooms, bathrooms or toilet facilities, changing areas, and therapy, counselling, or treatment rooms” (pg.7).
Having long campaigned against the use of vision-based technologies within England, the UK and globally, Stop Oxevision warmly welcomes this Code which sets out clear and robust safeguards as well as reporting and compliance requirements regarding the use of a wide range of vision-based monitoring technologies in Ireland. Where the code is particularly strong in its position regarding the use of technology within bedroom and bathroom spaces. It states that that any device must not be capable of recording (pg.17), and so it is fundamentally incompatible with any use of Oxevision within bedrooms – especially the way in which this has been implemented and marketed within the UK. It is also our understanding that the Code would further preclude blanket approaches of installing and using other surveillance technologies routinely within all patient bedroom and/or bathroom areas, offering patients protection against potential future technologies.
Summary of the Code and Guidance
The MHC/DPC Code opens with a clear stance that “The use of digital monitoring technologies, sometimes referred to as surveillance technologies, in mental health services raises ethical, legal and human rights concerns and may significantly impact a person’s right to privacy and dignity” (pg.1). It establishes a clear and unequivocal position that vision-based technologies should never be used to replace direct in-person observation of patients. The Code recognises that, especially in the context of acute illness, psychosis and past trauma related to monitoring and surveillance, “the presence or perception of digital monitoring technologies may exacerbate such distress or undermine therapeutic engagement” (pg.1).
In a similar approach to NHS England, the Code outlines the fundamental principles that must underpin any use of vision-based monitoring technologies. Importantly however, the Code substantiates these with strong and unambiguous guidance, statutory requirements for mental health centres to report their use of such practices, and clear commitments to regulating adherence to the Code. The ten principles emphasise fundamental tenets of care that must be upheld including: upholding patients’ Human Rights; ensuring technology does not compromise dignity; that consent must be sought and that technologies should not be implemented as a blanket measure; and following data protection processes. The principles rightly recognise that “prolonged and universal use of digital monitoring technologies may constitute an unnecessary and disproportionate restrictive practice” (pg.7).
The Code provides specific guidance regarding the potential use of vision-based monitoring within bedroom and bathroom spaces, outlining that:
“Digital monitoring technology should only be used in bedrooms and/or bathrooms, in rare and exceptional circumstances, where it is necessary and proportionate to prevent serious harm to the person receiving care and treatment or others, and there are no less restrictive ways available to manage the person’s presentation” (pg.17).
Importantly, it further stipulates that:
“Digital monitoring technology used in these areas should preserve the dignity of the person, not be capable of recording and any images captured should be pixelated or blurred” (pg.17).
It is our understanding that this precludes any use of Oxevision within Ireland on the basis that this technology both continuously records and is capable of recording, displaying and retaining clear video image.
The Code continues to provide direction regarding the use of other monitoring technologies outlining that the use of such devices must be initiated for an individual patient by a consultant psychiatrist and not used on a blanket basis. This aligns the processes for implementing digital surveillance technology with the procedures through which medical treatments, interventions or assistive technologies are prescribed and tailored for an individual rather than implemented as standard or used just because it’s available. The Code outlines that digital monitoring technologies should not be used for “prolonged or indefinite periods of time” (pg.17) and must follow a comprehensive risk assessment, including consideration of the impact the technology may have in exacerbating symptoms or negatively impacting the recovery of a person receiving care and treatment.
With regards to patient consent, the Code clearly outlines that within bedroom and bathroom spaces, “digital monitoring technology cannot be used where a person has capacity to consent and refuses consent” (pg.17). It further stipulates that if someone is considered to lack mental capacity under the Irish Assisted Decision-Making (Capacity) Act (2015) – similar to the Mental Capacity Act for England and Wales – the technology can only be used in consultation with a decision-making representative, following advanced directives and that “an independent consultant psychiatrist may approve or refuse” (pg.17) the use of the technology.
For all vision-based and surveillance technologies, including CCTV within communal areas, mental health centres must provide clear, accessible and transparent information to explain the use of technology. Such information must detail the lawful basis upon which the technology is used and give information about how to raise objections and complaints. Staff must receive appropriate training in the use of any technology and training must also address legal, ethical and Human Rights considerations regarding its use.
The Code outlines additional considerations where technologies are used in services caring for children, including ensuring that its use is in line with child protection policy and law. The Code recognises that:
“Digital monitoring technologies can have particularly adverse implications for the emotional development of children. This is to be taken into account in any decision to use digital monitoring technologies in approved centres providing care and treatment to children” (pg.19).
The Code outlines the need for mental health centres to take a cautious and measured approach to assessing the appropriateness of technology prior to its implementation, and the need to review its ongoing use. Centres will be required to complete detailed ‘digital monitoring technology impact assessments’ which will support independent evaluation and assessment of “the purpose, evidence base and potential effects of digital monitoring technology before it is implemented or to determine whether it should continue to be used” (pg.1-2). Such assessments require centres to consider the purpose of the technology, its evidence base, Human Rights considerations, whether there are less restrictive alternatives and issues of safety and data protection. Centres will also need to seek input from patients in the decision-making process. Additionally, centres will need to ensure that there are processes in place to review the impact and potential benefit(s) or harm(s) of the use of any technology for individual patients to ensure that it meets “the intended objectives to support continued use” (pg.7).
The Code will introduce requirements for centres to report the use of digital monitoring technologies. As outlined in the document’s appendix, containing template forms, appropriate records must be kept for each patient if monitoring technologies are used. Additionally, it includes mandatory requirements for centres to report the number of patients subject to digital monitoring technologies in bedroom and bathroom areas and the duration the technology was used for to the MHC. This reflects the nature of the use of bedroom monitoring as a form of restrictive practice that must be reported alongside seclusion and physical and mechanical restraint. NHS England requires monthly reporting of the frequency and duration of the use of restrictive practices from all NHS and private providers however this is currently limited to seclusion and forms of physical, mechanical and chemical restraint.
Consultation report
The MHC/DPC code was informed by stakeholder engagement conducted between April 2025 to April 2026. An additional consultation report outlines the process and summarises the views and feedback obtained from service users, family, staff and mental health and Disabled Persons Organisations. The report summarises that “overall, respondents were strongly against the use of digital monitoring technologies in bedrooms and/or bathrooms” (pg.13). Respondents to the initial questionnaires identified numerous concerns with the use of vision-based technology in bedrooms:
“Respondents also highlighted a number of negative impacts, such as invasion of dignity and privacy, potential to exacerbate symptoms, reduced human interaction, power imbalances and the risk that it will act as a barrier to recovery […] Concerns were also raised regarding data protection and unauthorised access to data. One service user feared that data gathering by digital monitoring technologies could be “used against them”. Others raised concerns about confidentiality and privacy” (pg.13).
In subsequent focus groups with people with experience of treatment on mental health wards, similar concerns were expressed:
“It was suggested that digital monitoring technologies have the potential to be detrimental to recovery, especially those experiencing psychosis, paranoia, trauma or stigma […] Many participants were concerned that increased use of digital monitoring technologies in mental health services would be a cost cutting exercise to reduce staff numbers and this would negatively impact on care and treatment, in particular the therapeutic environment and therapeutic relationships. Participants believed that enough skilled, suitably trained and qualified MDT staff should negate the need for digital monitoring technology” (pg.17).
It is further reported that:
“One participant noted that the rising use of surveillance technologies in mental health services in the United Kingdom is a result of a sales drive by tech companies and questioned whether there is any evidence or research to demonstrate its positive impact on care and treatment” (pg.17)
Focus groups held with family members identified similar concerns:
“Participants had significant reservations about the increased use of digital monitoring technologies in mental health services. They believed that this represents a move away from person centered care and would negatively impact on the therapeutic relationship between staff and people receiving care and treatment […] Most participants who attended this focus group believed that the use of digital monitoring technologies in mental health services is an invasion of privacy” (pg.18).
Additionally, most staff were against the use of digital monitoring within patient bedrooms and felt that technology should not be on a blanket basis and were concerned about the impact on staffing and therapeutic support.
This feedback reflects the concerns we have heard from patients, carers, bereaved families and staff throughout our campaign, reflecting a broad consensus that monitoring technologies within bedrooms and bathrooms are not welcomed by those the technologies are designed for.
Summary, implications and contrast to the approach of NHS England and CQC
Stop Oxevision, welcome the MHC/DPC Code as an important step in ensuring that any potential introduction of vision-based monitoring technologies within Ireland is lawful, proportionate and safe. We commend the proactive steps that have been taken to establish a clear regulatory framework at an early stage, in recognition of technological advances, prior to these having become widely embedded within Ireland. Adopting a unified approach between statutory powers and a commitment to monitor and enforce their implementation, the Code provides both guiding principles and clear direction regarding how such principles are actualised to uphold patients’ rights.
The approach taken by the MHC within Ireland is a stark contrast to what we have observed in England. Over the past decade, a wide range of vision-based monitoring and surveillance technologies have been rapidly rolled out across mental health services – as well as more broadly within the NHS and social care – particularly within England. This includes Oxevision, body-worn cameras, Care Protect and traditional CCTV systems in communal areas, seclusion rooms and 136 suites. Despite this rapid proliferation of technologies, regulators have failed to keep pace, update guidance, or ensure that such use is safe, lawful or evidence-based. Conversely, public funds have been funneled into schemes such as the NHS Innovation Accelerator and Health Innovation Networks to promote wide and rapid implementation of innovations whilst private companies capitalise on the lack of oversight and regulation.
As Stop Oxevision, we have campaigned against the use of Oxevision for over three years. It has only been through our efforts, as well as those of patients, carers and bereaved families, that regulators including NHS England and CQC finally took action and issued direction regarding the use of surveillance technologies. This action was too little, too late. Despite years of patient activism, complaints, Prevention of Future Death Reports, and mounting media attention, the position of NHS England and CQC remains ill-articulated, inconsistently enforced, and poorly regulated. Agencies have failed to form an appropriate, united regulatory framework, with the positions of those few who have not remained entirely silent being fragmented and siloed, hampered by what appears to be efforts of agencies to ‘pass the buck’ and deflect their own responsibility.
In this context, we commend the position of the Irish MHC and urge equivalent agencies in other countries to take heed of this strong precedent and adopt a similarly strong commitment to upholding the rights of patients, resisting the powerful influence of private for-profit companies, and taking a proactive stance amidst rapid technological advances to ensure the safety, dignity and rights of all.
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