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. Itas, 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; Science Foundation Ireland and other bodies supposedly engaged with improving the standard of mental health provision in our country.

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 Boyne 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 (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.  ‘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 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, counseling etc. There is an Oratory.  The staff are approachable and pleasant. But then this is not a stigmatised illness. There is HOPE.

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. Vincents 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 mixed.  Anger 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)