While it has played a significant role in raising awareness and providing services, the organisation has faced several controversies concerning its financial management, governance, and operational practices.

[3] In 2020, the charity implemented salary reductions of up to 30% across all staff and announced redundancies, citing a budget shortfall of around €6.5 million due to the COVID-19 pandemic and the postponement of key fundraising events like Darkness Into Light.

[6] The audit found controls and oversight at the charity, which received €5 million in HSE funding over the past two years, were “unsatisfactory”, and made more than 50 recommendations for improvement.

The audit also revealed that salary increases awarded to the then-CEO and senior staff in 2017 were not formally discussed or approved, as evidenced by the absence of these decisions in board meeting minutes.

In addition, the audit noted inadequate performance monitoring, including failures to centralise essential documents such as tax clearance certifications and insurance policies.

It noted that “Pieta House management were not fully informed about the ambassador’s activities,” and her contract and job description were missing from her staff personnel file.

Issues included the use of pre-signed blank cheques, inadequate control measures for electronic banking, and failure to adhere to public sector procurement rules.

Concerns have been raised about Pieta's workplace environment, with reviews from self-reported former employees alleging poor treatment, high staff turnover, and a toxic culture.

For instance, a former psychotherapist described the organisation as having "terrible management" and noted that "very few stay long term due to the poor running of the workplace and treatment of staff."