A chara, – Frank Browne raises concerns about our inadequate services for the mentally ill, both prior to receiving prison sentences and after release (Letters, November 18th).
One can add to this situation the plight of anyone released from an acute psychiatric unit after either voluntary or involuntary treatment. He correctly identifies the problem as being one of “minimal follow up” where people may “relapse and become a danger to themselves and the public”. I agree that adequate, community-based, mental health services have never been developed since the closure of our public psychiatric hospitals, resulting in the current crisis of too few acute beds and a system of “revolving door patients” from acute units.
However, I would question the ability of community treatment orders (CTOs) to rectify the situation. The Mental Health Act allows for involuntary treatment of mentally-ill persons, while the evolved practice of “leave of absence” from acute treatment facilities further allows patients to live in the community under a de facto CTO. I strongly lean towards the view that involuntary treatment orders should be used very sparingly. Legislation to extend involuntary treatment into the community needs to be carefully implemented, if at all. Nevertheless, this is not the real problem; CTOs will change nothing if community treatment and accommodation facilities are unavailable or scarce to the point of being useless.
It is well past time for Minister for Health Stephen Donnelly to review the situation that sees many previous mental health facilities lying empty and unused. A programme of upgrading and improving these could be undertaken immediately alongside the construction of other community-based accommodation for discharged patients or released prisoners
Action is urgently required if we are to once and for all deal with our completely overwhelmed acute psychiatric services. – Yours etc,
LIAM O’GRADY,
Association of
Professional Counsellors
and Psychotherapists,
Galway.