Madam, - The details of the annual report by the Inspector of Mental Health Services (The Irish Times, July 23rd) calls for a public outcry - an outcry so loud that it shames every psychiatrist, psychiatric nurse, health board official and public representative, particularly the Minister for Health, into the awareness that they have been derelict in their responsibilities.
It is shameful to think that the most vulnerable human beings in our community are treated as sub-human, warehoused in sordid environments best described as human zoos, concentration camps most foul. How could anyone placed there be expected to get well, to emerge intact and take up their life again? How can any parent rest knowing that their loved one with special needs is being subjected to grossly inadequate long-term care environments?
The fundamental tenet enshrined in the Hippocratic oath, "First do no harm", does not seem to have a place in psychological medicine. Has the true meaning of the word psychiatry, that of "soul-healing" (from psyche meaning "soul" and iatriea meaning "healing") been abandoned? Why do psychiatrists collude with such an appalling system of care? As a psychiatrist I can only answer for myself - fear about being the one to rock the boat.
It is difficult to speak your truth when you have little or no support. Who wants to be treated as an outsider, to be labelled a rebel, a troublemaker, or a whistle-blower? Who wants their misgivings about the lack of psychotherapy, the excessive use of medication, the increasingly powerful influence of the drug companies, the dangers of electroconvulsive therapy, the unconstitutionality of involuntary detention and the need for open discourse to be met with strident opposition, and libel actions from colleagues? It has happened to me, and it's a hideous experience.
Here's the real dilemma: you're caught in a double bind. If you remain silent you become morally bankrupt; if you are authentic you risk abuse and ridicule. All those witnessing the indefensible inadequacies in the front-line care of the weak and vulnerable should remember the words of Martin Luther King: "Our lives begin to end the day we become silent about things that matter." - Yours, etc,
MICHAEL CORRY,
Consultant Psychiatrist,
Eden Park,
Dun Laoghaire,
Co Dublin.
Madam, - The Minister for Health's recent criticism of the facilities for patients at the Central Mental Hospital is welcome and justified. She has stressed the urgent need for major development of the forensic psychiatric service.
Further criticism is contained in the report of the Inspector of Mental Health Services.
Ms Harney's predecessor, Micheál Martin, visited the hospital in February 2004 and he too gained first-hand experience of the very same conditions, which Ms Harney has again highlighted. Likewise, the previous Inspector of Mental Hospitals, Dr Dermot Walsh expressed his concerns in annual reports year on year.
Ms Harney has a proven track record in bringing about change. We trust that her recent criticisms will now be translated into a firm and immediate action plan, which will provide a national forensic psychiatric service of which all of us can feel proud. - Yours, etc,
Dr DAMIAN MOHAN,
Chairman,
Dr HELEN O'NEILL,
Honorary Secretary,
Faculty of Forensic Psychiatry,
Irish College
of Psychiatrists,
St Stephen's Green
Dublin 2.