Emails to Politicians, Consultants, Senators et al: No dignity afforded to Mental Health patients in Dublin 4 by Michelle Clarke

Subject: Inadequate coverage by mental health/vulnerable people
Date: Fri, 8 Jan 2010 18:10:55 -0000
From: Michelle Clarke
To: Gillian Markey <gmarkey@hrb.ie>, joan.burton@oireachtas.ie, JMoran@amnesty.ie, Doherty, Colin (Neurology Consultant) <CPDoherty@STJAMES.IE>, Nigel Dodds <ndodds@dup-belfast.co.uk>, Health & Safety Authority <newsletter@hsa.ie>, ASenkara@amnesty.ie
CC: Hugh Kane <hugh.kane@mhcirl.ie>, Martina Dumpleton <martina.dumpleton@barnardos.ie>, Dara Duffy <Dara.Duffy@rehab.ie>, John Doyle <johndoyle@disability-federation.ie>

Friday 8th January 2010

Dublin 4 and Human Dignity

KT:
A few days ago I tried to help a homeless man.  I walked him up the steps of Baggot Street Hospital.  I did not ask, I actually pleaded with members of various staff – was it possible to give this human being a bath.  His clothes were drenched in urine and the smell was very bad.  At one time, this man had a life, a former civil servant.  The response from Baggot Street Hospital was not unexpected – not in the least, it was ‘we don’t do this – it is not part of our work agenda – we don’t have the staff.  Myself and my homeless friend walked out.  He turned to me and said thanks for helping and with a wry smile said ‘I will always hope Kevin – I am a survivor but again thanks for helping’.  (KT had clothes in a bag for him).

 

Michelle:

Why?  This was I learned recently quite an exceptional Accident and Emergency in times gone by.  I have met and been impressed by retired medical people who are a part of a social history of this once esteemed hospital that is now abandoned to categories of medical support that deal with basically the voiceless.  It stands resplendent in architecture and the memories of times of yore when medical staff worked long hours, were dedicated, ambitious for a future. 

Personally, I can speak of my experience as a psychiatric patient there.  The choice is clear, the front once elegant stairway or the shoddy side entrance on Haddington Road.  Psychiatric and I am talking about 2006 (thankfully, I could change to a private psychiatrist), one’s lacking self esteem channeled you through the side entrance, humbly nodding at the security man, and passing by the area that catered for people with drug addiction – so many young addicted people, and all I can say is there was nothing in the environs to inspire that sense of hope. 

For the psychiatric patient (community supposed support) – there is another security guard and a bell to ring.  People forget that people with neuro-psychiatric problems also encounter other difficulties, sometimes it is anxiety and more times it can be intellectual disability and doing basic functions like ringing the bell system becomes an embarrassing muddling task.  Inside this big ominous room are the seats to sit on and the little sub offices that houses the psychiatric team – the social worker; the public health nurse; the secretary; the consultant (never met her); the junior doctors – often young foreign doctors who have difficulty comprehending mental health particulars in such a raw environment.  I do not wish to depress people but I do wish to state and re-state one point that I deem most unfair:-

A young man, maybe too much alcohol, a little homeless, mixed up on which medications to take, switches location from northside to southside, who is trying to break the system of regimen and rules that allow the staff to say ‘No medications here this week for you’.  They fail to relate to his fear of medications stopped and confusion and when he protests too much for their liking they call the local Gardai – two in number to remove him, minus his medications and in his confusion.  How many times are the Gardai called out to mental health situations these days?    I made a point of walking out with this man and asking the Gardai to treat him with dignity as in the Constitution. 

Why?  What about the medical profession and their humanity and responsibility and their working together with people like Alice Leahy, Trust http://www.aliceleahytrust.ie/.  How can such a hub for co-ordination of vulnerable members of society (addicts, mental health community assistance, elderly) operate on what appears to be a 4 day week.  Where is the common sense?  I used to have bloods (Lithium) taken but now me and others must go to Vincent’s hospital.  Where is the community health aspect of medicine for the Dublin 4 area?  There are too many solo runs and insufficient integration.  Mr. Keane it appears, has turned his Centres of Excellence for Cancer Sufferers, into a successful inspirational entities.  Why can we not have the same for Neuro Mental Health Addiction Youth to Aged  Suicide, Education  Research – the Building is crying out to revive its history and potential?

Human Dignity is vital.  People who are homeless live along the Canal, live in the likes of Herbert Park, yes in this appalling cold.  No longer are there places to wash and clean or even basic facilities.  KT speaks of this man and their pleas for assistance at Christmas Time.  I ask where is the Public Health Nurse and why in such a large hospital, can we not provide facilities for homeless people, through charity if needs be, to ensure that people who do not qualify for medical cards because they have no fixed abode can gain access to free health provision, and facilities that are available to people if they are admitted to hospital (unclean) through say Accident and Emergency.  This was part of the role of a district nurse within the last three decades so why such change!  Yes hours of work for medical people were considerably longer then but value for money appears to be a high cost for those who are the vulnerable members of our society.  Teeth:  Addiction, psychiatric medications, vulnerabilities, sickness, homelessness.  Just look to a person’s mouth and its condition and it is one of the great indicators of a state of health.  Why in Ireland do we not provide proper dental treatment for people?
 
KT
As I walked away from the homeless man who was refused a bath at Baggot Street hospital, I crossed the road, morally sadly facing the FAS office and my flash backs were of Roddy Molloy, pensioned off with a lump sum for wasting millions of taxpayers money and also of a man in his late 40’s in the height of the Tiger (Bertie’s Tiger) Bluff.  This man spent 16,500 euros in the area of Dublin 4 – lunches, wines, and for what – the result – a reduction in welfare payments.  What have we become?  My friend went back to the Canal wall – as usual he lights a little fire.  His face is black with smoke – o yes, society is right, it is his choice but I ask the question again Why?  Three weeks of Cold weather, snow, frost.  How many will die? 
 
The question I ask now is:  we have had the floods literally and the corruption floods – we now have the Church in turmoil, we have Gerry Adams in hiding as a moral bankrupt, we have the Robinson DUP Dynasty in Tatters, Mental Health, Suicide yet we have a lot of questions to ask Sinn Fein in relation to alleged Child Abuse.  Adams is the Leader or some say the Master of Sinn Fein.  He now has a problem for once in his life – there are no moral exits even through Clonard Monastery – he must fill in the gaps and let his brother Liam face Due Process (22 years is a long time and there are lots of questions). 
 
Gerry Adams now, a man that proved himself by bringing Peace, with others, to the Island of Ireland and that will always be in his Memoirs but his chance now is to Lead from the Front, forget the Church, the Closed Circles, the ‘Church Male Monarchy and just tell the pain he is experiencing in his life, like others who have been affected by sexual abuse.
 
Back to morals and Irish Society – some people are now trying to mock Honohan in the Central Bank.  Here is a decent man – so why the mockery?  You see the Divide of Life is so thin.  Society also mocked the homeless and gave him no bath.
Quotation
Health
Jiddu Krishnamurti (1895-1986) Indian Spiritual Philosopher
‘It is not a measure of health to be well adjusted to a profoundly sick society’
 

Subject:

Mental Health: The Stigma. The inadequate primary care provision. The lack of beds for those in need. Children who have mental health issues…..Suicide and the loss to suicide.

As Prof. Malone (St Vincent’s University Hospital) said…the loss is two: firstly the dead person but secondly the loss to the bereaved.

Date: Fri, 20 Aug 2010 22:06:45 +0100
From: Michelle Clarke
To: Andrew Harkness <aharkness@imhc.ie>, colm.mccarthy@ucd.ie, Constantin Gurdgiev <gurdgiev@gmail.com>, Contact <contact@tascnet.ie>, “daniel.neville@oireachtas.ie” <daniel.neville@oireachtas.ie>, Fíona Ní Chinneide <FNiChinneide@iprt.ie>, Hugh Kane <hugh.kane@mhcirl.ie>, humanrights@nuigalway.ie, “James.Reilly@Oireachtas.ie” <James.Reilly@Oireachtas.ie>, “jim.mcdaid@oireachtas.ie” <jim.mcdaid@oireachtas.ie>, Jim.Walsh@oireachtas.ie, “jimmy.devins@oireachtas.ie” <jimmy.devins@oireachtas.ie>, marcella_luz@health.gov.ie, thefrontlineaudience@rte.ie, tilda@tcd.ie, Liam-IPRT <LHerrick@iprt.ie>, Trust Ireland <trustire@indigo.ie>

Monday June 21, 2010 15:58

Dublin Hospitals scoop four awards: heading in a local newspaper

by Michelle Clarke

Does anyone think there is a total mismatch in reporting by the media?  You listen to RTE news and watch the TV and read the newspapers and all that is portrayed is the negative impact to our health system; the myriad of inadequacies, much of which is covered in the foregoing postings. The views of Accident and Emergency trolleys indicate expectation.

Today’s Irish times covers mental health and its need for priority. It is now 5 years since the supposed Blueprint from Government to MODERNISE mental health services and in the meantime the supposed property landbank i.e. including the properties of St. Ita’s, St. Brendan’s etc. has devalued by near 100% and that is if the properties are even marketable.

All we seem to hear about these days are Awards that our hospitals receive and yes those Centres of Excellence. Well the community hospital in Dublin 4 is no recipient of such awards. It is a crying disgrace and yet it is in the same locality as the Mental Health Commission; the Health Research Board; etc.

Malcolm R. Garland MD, Senior Lecturer in Psychiatry, Royal College of Surgeons writes to the Irish Times Editor today: The title is re-inventing ‘asylum’ buildings. His first line mentions the Mental Health Commission’s statutory powers to order the closures of St. Brendan’s, St. Ita’s and St. Senans and he refers to the inhumane conditions people are contained within in these hospitals. However he asks the poignant question? ‘Are we throwing out the baby with the bath water’. I say yes because we have no community services for the people we release from these inhumane hospitals at a community level. We have wasted time, money, potential, resources just neglecting our most vulnerable members in society – yes those diagnosed with a mental illness, those who at times need periods in hospital to regain a balance in their existence, are hounded further by Society.

This is of significance to me today. I was in a public hospital a decade ago because I needed a haven. I was in a ward and all I really recall was the friendship of an elderly former teacher. I had been in hospital for months and the day I was leaving Eleanor, distressed gave me a hug as I said good bye and gave her and the others in my ward a bar of chocolate. To this day I stand ashamed but I did what I could. She told me what she planned to do. I listened and I even pleaded with her not to hurt her family, her children. I told the nurses who continually take notes i.e. (avoid contact and engage in functional administration) and I left the hospital and that day so did Eleanor. She did as she told me and her body was found in the river.

I came out to family and friends and a degree of understanding but what about others? What about when your family tires of your bipolar or dystonia episodes. Mr. Garland is right to ask in today’s Irish Times where are the replacement acute units for people with mental health problems?  We must add to this people who have addictions, phobias, social anxiety, young people who give up school due to anxiety problems. Mr. Garland may have a good point about the locations of these hospitals and their link to nature.

The last line must ring out to those who look so weary when they talk about mental health i.e.

Minister for State Mr. Moloney (who at least has the courage to appear on the Vincent Browne TV3 show…..)
Dr. Siobhan Barry, College of Psychiatry of Ireland
Mr. Hugh Kane, the Mental Health Commission
Mr. Rogan, St. Brendans
and Mr. Garland, of course……..’Is a small cramped admission unit, with little or no access to outside space, the best place to recover one’s mental health? Can we transform it into a place of Vibrancy, Dignity and Recovery?

Discrimination and stigma says no. The funds were supposed to have been ring-fenced but the evidence suggests otherwise!

Yet I had occasion to go to Harold’s Cross Hospital on several occasions this week. Here is a facility that is a Centre of Excellence. There is a large building with bold print stating Education and Research on the Grounds (a source of inspiration for a person with a life time diagnosis).  The standards are beyond belief. Each ward, one after another, is spotless. There is a rest room with views to the grounds. The literature abounds about Arthritis and how best to engage in palliative care, physiotherapy, counselling etc. There is an Oratory. The staff are approachable and pleasant. But then this is not a stigmatised illness. There is HOPE.

Observation

I applaud the standards but what really concerned me was the lack of patients. If one was doing a cost benefit analysis one would reckon that spatial to person had an underlying profit factor for the architects, engineers, developers etc.

When I called at the weekend. My friend was gone but then so was everyone in the ward and the other wards; they were parceled out nicely for the weekends and all that remained were the staff. My friend was transferred to the main building to a room and again he had staff surrounding him but no patients.

To all in Government: It is time to look at quality and space utilisation revolving around the potential and actual care of people. I read the web page for the consultant based at St. Vincent’s Hospital and I note that there is a waiting list in excess of 5,000. What is the problem? Is this about private care in a public hospital or what is it?

Mental health is vital and it is extremely important to have community services in place and acute units when the need demands. We call for a referendum for children but in the meantime we are leaving children open to vice, suicide, being murdered etc.

Add to this the conditions in the Central Mental Hospital……where is the hope?

Michelle

Quotation from a man eminent in his field of research in decades gone by:

Michael J. Kelleher was a clinical director with the Southern Health Board, consultant psychiatrist and the founder of the Suicide Research Foundation in Cork.  He was a member of the Department of Health National Task Force on Suicide…..he had extensive experience in working and lecturing abroad….

He is not to be forgotten. 

(Book:  Suicide and the Irish 1996).

About tipping the balance…the real cost of anxiety!
‘Anxiety is a sense of dread and apprehension about the future. It is associated with a loss of confidence and a loss of assertiveness.  Although, if a person is threatened, he may respond with a vehemence and anger that surprises even himself.  There may be a fear of going out, as well as a fear of being alone.  Added to this there is a gnawing fear that the suicide will be imitated – by oneself, as sometimes happens; or by children or siblings, as is more frequently the case.  Depression and Anxiety are often mixedAnger and a need to apportion blame are common experiences.  Recourse to alcohol or medicinal drugs (in particular the benzodiazepines, which are commonly prescribed for both anxiety and sleep) is a further hazard.  The individual’s future emotional and psychological health will be determined by how he or she responds to these unforeseen stresses.  It is important to emphasize that it is natural to feel pain.
In a sense emotional pain helps to cleanse our minds, at least initially (page 73)

2016 – Centenary of the 1916 Rising

Many emails, many letters, no change other than a press statement that the Royal City of Dublin hospital was for sale; subsequently selling agents took off the market and were awaiting instructions from the HSE.
It is now 2016:  Progress.  No most definitely not.  Another name but a Task Force is scheduled for September 2016.
A response at last but so few believe in feedback in Ireland.
Thank you for the many points in your letter.  I have opposed the sale of Baggot St hospital in the Seanad and will seek to have it reopened.  I admire Owen Sheehy Skeffington immensely. Recently I was part of the Seanad move to end the chastisement of children and Minister Reilly accepted the motion. Skeffington was part of the inspiration as a lifelong opponent of corporal punishment of children.
Senator Sean Barrett

On Wednesday, February 3rd, 2016 at 8:12 PM, Michelle Clarke to Lara Kelly, Mental Health Reform https://www.mentalhealthreform.ie
It is me again!  Election time and mental health.  I keep asking the same question.  Sean (Fleming) – you have sent me figures but it is not what I am asking?  Shari and Laura (Mental Health Reform) – I have received your replies but you are not answering my question.  The scandal re Grainne and Anne (foster care and costs) makes me ask you once again.  It comes down to money paid and outlining exactly what the cost is to the State when providing a bed in a public psychiatric hospital in Dublin 4. The person I know is now approaching two years in St Vincent’s Mental Health unit (Elm Mount), Dublin 4.  The costs are paid by the HSE.  The last day I went to visit I was sent to three locations in the hospital and eventually met the man in his ward with a member of staff in St Vincent’s main hospital – to be told ‘X has his liberty’ ie he is gone out.

Mary Lou McDonald, Sinn Fein, asked at the Public Accounts Committee yesterday:  How much were the foster parents paid by the HSE for Grainne and Anne?  Mr O’Brien’s (HSE) inability to answer such a direct question brought me back to my direct question I have been consistently asking over the past 2 years.  If you are admitted to a HSE hospital surely like in the case of Grainne and Anne or X in my case; there is a contract and a duty of care; their is an economic cost and prognosis.

If I am admitted to St Patrick’s Foundation hospital (private).  I need my credit card before I can be admitted.  The cost is stated by the hospital because if you cannot pay you cannot be admitted.  If I have VHI there are conditions as too how long and how often I can stay.

Again:  The HSE allocate a bed to a person known to me, they supposedly provide treatment and outcome.  How much does it cost per month?  It is the taxpayers who pay.  I have reason to believe it is e28,000 per month.

The Long Room Hub Trinity College Dublin: Lecture 4 pm today concerning Mr Sheehy-Skeffington.  The lecturer remarked about the extensive archives of this Senator and the level of detail in the archives.  It was of that era when people received a letter, annotated the reply and then gave feedback.  This is something that digital has destroyed for historians in the future.

Regards

Michelle Clarke


On Thursday, February 4, 2016 at 7:16

Consistently by email, by twitter and other means I have asked a very simple question.  If a patient is in a public psychiatric hospital in Dublin 4 for 18 months, how much does the HSE pay for all costs associated with the Bed?  Nobody can answer the question directly.  Why?

On 04/02/2016 11:29, Lara Kelly wrote:

Hi again Michelle,

I’m not sure there is a single answer to your question, at least not one that we can easily find by looking at HSE and other reports. I’ve asked my colleague, MHR’s Research and Policy Officer, to see if she can find anything more out than what I sent you last year.
She has had a look at this HSE report: http://www.lenus.ie/hse/handle/10147/88893
This report, called The efficiency and effectiveness of long-stay residential care for adults within the mental health services evaluation report prepared under the value for money and policy review initiative, 2008, reported on costs per bed per day. The costs below are based on staff costs only (i.e. not overheads, electricity etc); the most significant portion of costs are staff based, with 88% of total costs directly attributed to staffing. Non pay costs (which account for 12% of the total cost are not included here).
  • Staff cost per bed per day (high support) ranges from approx.€0 – €288
  • Staff cost per bed per day (medium support) ranges from approx. €0 – €145
  • Staff cost per bed per day (low support) ranges from approx. €0- €82
  • Staff cost per bed per day (long-stay in-patient unit) ranges from approx. €0-€312
(Please note that my colleague pulled these costs from data illustrated in maps in the report – if you are using this data publicly, I would recommend double checking it with the HSE). 

There are significant differences in the staffing levels across mental health catchment areas, leading to significant differences in the cost per bed per day.

I hope that’s useful,
Best wishes,
Lara

From Michelle Clarke to Lara (Mental Health Reform)

Thank you for going to all this effort.

An Taoiseach has written several times to me referring the matter to Leo Varadkar, Minister for Health.  Needless to say if the matter is ignored; the problem will go away is their mantra.  Sean Fleming, Fianna Fail,  has tried to access detail but like you he gets a proportion of the detail but not a cost like one would be presented with if entering a private hospital and paying by VHI or other healthcare packages.

I attended the lecture in Science Gallery in Trinity about Taboo ie Mental Health related.  I used the opportunity to ask the host Mr Graham Love, HRB and also Ms Helen Coughlan Social Worker, the same question.  They didn’t know.  I used their twitter but again no replies.

There was a recent court case about mental health patients who were ‘beyond’ treatment services in Ireland; they were juvenile and one reached the age of 18 and said she wanted to return to care in Ireland.  The Judge was concerned at the costs of Stg6000 pw.  He asked the question what could be achieved if one took this annualised sum?  I ask the same question regarding a patient in a public psychiatric hospital in Dublin 4.

All we want to know is what does it cost SVUH to keep a patient for 18 months:  If we establish the cost then we really can question the treatment?

Lara again thanks.  I know the answer is hidden by a cloak of secrecy?

Outsider Art and Brent Pope.  There is a future for people with Bipolar/Schizophrenic diagnosis.  I spent considerable time in psychiatric but someone saw beyond the label and I escaped the revolving door.  I am trying to help my friend’s son.

If the Royal City of Dublin hospital is for sale – I have outlined my ideas on my WordPress.com canisgallicus site.  Already the mental health patients have been told by a note on the door on a Friday that as of Monday Go to Clonskeagh.  Heartless lack of understanding of the complexities of mental illness, drug addiction and related.

 


Recommendations:

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One Response to Emails to Politicians, Consultants, Senators et al: No dignity afforded to Mental Health patients in Dublin 4 by Michelle Clarke

  1. michelleclarke2015 says:

    Reblogged this on canisgallicus.

    Like

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