Sir, – Watching RTÉ Investigates confirmed that “the more things change the more they remain the same”. The programme focused on A Vision for Change, a report on mental health service provision 20 years ago. I clearly recall being at the launch of that report and, to the annoyance of many people, I asked the junior minister at that time if he would propose meeting in 10 years to assess its progress. This question was asked based on my daily experience – peppered with a degree of cynicism.
The first report on people with mental illness was compiled as far back as 1851. In June 1972 Prof Ivor Browne compiled a report on the development of community mental health services, which contained a broad outline of proposals for the development of psychiatric services in the Eastern Health Board area. The report was based on experience gained over a number of years in attempts to improve psychiatric services. He said the health service was proceeding with a programme for placement of long-term patients in various hostel situations within the community.
The aim of the policy was to break up the existing mental hospital complex with its excessive concentration of patients in large institutions. This was to be done “by a comprehensive range of facilities, largely based in the community, which will provide a more humane, therapeutic and realistic environment for the care and treatment of patients who had been rejected by society and forced to seek asylum in large substandard, antiquated and dehumanising institutions”.
Many people, this writer included, campaigned for and welcomed the closure of these institutions. Working in the field of homelessness for 50 years, we meet too many people with serious mental health issues ending up in prison, and families and concerned individuals struggling to get even a listening ear – an email or voicemail is no solution. Over those years endless reports have been written, millions in taxpayers’ money spent, endless seminars and conferences held, and increasing numbers of experts and politicians have come and gone. The use of technology coupled with corporate speak and box-ticking can give the impression that all is well. This helps to dismiss the real pain and allows real human interaction to be ignored.
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In 1985, when yet another report was published, titled Planning for the Future, we contacted the then minister for health to outline our concerns about hostels and night shelters becoming dumping grounds as hospitals continued to be emptied.
In more recent years the NGO sector has become more involved in the “care and rehabilitation” of people with mental health issues and housing. Another example of the State offloading its responsibilities. There are some examples of great work but a lot more needs to be done.
People can be institutionalised and feel like outsiders in a struggling community with no joined-up thinking between those providing the housing and those caring for their medication needs. People in the community also face unwarranted difficulties when attempting to raise concerns for their fellow citizens.
Now, 41 years later, prisons have become the dumping grounds, with the Garda the only help available in an emergency. This can lead to a court appearance and eventually admission to prison – even, at times, outside this jurisdiction. The patient then becomes the prisoner or “inmate” with the added stigma attached.
The RTÉ Investigates programme will probably lead to much-needed debate but it will be meaningless unless action takes place. This action must involve frontline workers, people experiencing mental health problems, their loved ones and concerned citizens, with an acknowledgment that our fellow human beings deserve better in a modern, wealthy European country. – Yours, etc,
ALICE LEAHY,
Director of services,
Alice Leahy Trust,
Dublin 8.
