The patient in the St Patrick’s Mental Health Services case was seven or eight when he was sexually abused by an elderly cleric in his home town.
The abuse took place up to five times over the course of a summer. “I can recall trying to get out of the room. He had an old-fashioned walking stick which he used to stop me leaving,” the victim said.
He told no one of his experience at the time. The cleric died a few years later, in the mid-1960s.
The man got married in his 20s but experienced severe facial pain during sex. From 1980, he attended a doctor who diagnosed anxiety and an obsessive personality and prescribed benzodiazepines. Now in his 60s, he has been on tranquillisers ever since.
In 1988, the patient began seeing Dr John Griffin, then a consultant psychiatrist at St Patrick's Hospital in Dublin. He saw Dr Griffin privately, with his health insurer bearing the cost of treatment.
He was hospitalised four times for his condition over a 21-year period and tried several times to “detox” from tranquillisers, with limited success. His behaviour was often erratic; he lost heavily at gambling and went missing on one occasion.
There is a difference of opinion on when the patient’s sexual abuse first featured prominently in his therapy. Dr Griffin told the review he was first informed about the abuse “late in the relationship” in 2009 and said he provided intensive psychotherapy at every subsequent consultation.
Private notes
The patient said he raised the issue of the abuse in 2005. He said he told Dr Griffin he always had an awareness of the abuse but, at this time at least, was not unduly worried by it.
Dr Griffin’s private notes make one reference to the abuse in 1999, but neither the patient nor Dr Griffin recalled this until it was brought to their attention during a subsequent review. It states: “It is not clear from the notes what, if any, psychotherapeutic approaches were used and there is no reference to referral to a counselling service until 2009.”
In time, the patient grew more concerned about the role abuse might have had in his mental health problems. It is agreed that in 2009 an addiction therapist at St Patrick's referred the patient to Faoiseamh, the counselling service set up by the Catholic Church for victims of clerical sexual abuse.
Excess medication
“She said that all I have been doing over the years is running away from the effects of the sex abuse by gambling and taking excess medication to block out the symptoms of the sex abuse,” the patient said.
A later review of the case notes: “By 2014, [the patient] had been taking Xanax more or less continuously for more than 20 years and had been taking benzodiazepines for more than 30 years.”
By 2012, the patient had informed the medical director of St Patrick's, Prof Jim Lucey, of his dissatisfaction with the care he was receiving. He claimed Dr Griffin had failed to address the sexual abuse and that his life had been damaged by being on benzodiazepines for so long.
Dr Lucey said he could find no fault in Dr Griffin's management of the case, but advised the patient he could make a complaint to the hospital or the Medical Council.
The patient, who was sleeping poorly and having flashbacks, became increasingly unhappy about the way the sex abuse issue was being handled and threatened legal action in 2012. In May that year, Dr Griffin wrote a series of personal letters to the patient about his own medical issues.
Agreement
In late September 2012, the patient went to see Dr Griffin, who discussed making him a payment.
“He then wrote down a financial figure on a sheet of paper on the table in front of me and asked if this would ‘settle it’,” the patient said. “I nodded my agreement as I personally wanted this finalised.”
Dr Griffin wrote a post-dated cheque for €50,000 and composed a short note for the patient to sign. It said he had agreed to pay the amount “in full and final settlement for medical services without admission of liability”.
Since 2014, the patient has been seen by other psychiatrists who have identified his child sexual abuse as a main factor in his condition. One wrote a letter of complaint which led to the setting up of a formal review into the patient’s care.
Described by St Patrick’s Mental Health Services (SPMHS) as independent, the review team comprised one administrative and one clinical staff member as well as a lay person. The lay person interviewed Dr Griffin but did not participate in the interview of the patient.
Shortfalls
The patient then sought compensation from SPMHS for the suffering borne by his family as a result of the issues that had arisen.
Last November, SPMHS chief executive Paul Gilligan wrote to the patient apologising for shortfalls in care "which were the responsibility of Dr Griffin".
Mr Gilligan rejected the request for financial compensation “because your complaint relates to practice dating back to 2005 and primarily concerns Dr Griffin’s private practice”.
In a further letter to the patient, Caroline Preston, chairwoman of SPMHS states: "Some of the consultants employed by SPMHS are entitled to engage in private practice and in such circumstances governance and responsibility for this private practice rests with the consultants themselves."
Today, the patient feels taking the cheque from Dr Griffin was “the wrong thing to do” but points out he was heavily medicated at the time. He is also angry “that the cure for everything lay with a pill” for so long and that he is condemned to continue taking pills for the foreseeable future.
