In all the recent election debates, there was just one mention of mental health. Only one party (Fianna Fáil) gave much more than a paragraph to the subject in its manifesto. Nobody won or lost a seat based on it, although it’s been acknowledged now for quite some time that both the health service and the mental health of a large proportion of the Irish population are in crisis.
Just after the same election, former Minister of State Kathleen Lynch gave an interview suggesting the lack of priority given to the area in the last budget was such that she almost resigned. She got the money ringfenced for mental health, and stayed put.
Since then, with no government and no prospect of one any time soon, mental health has fallen back off the public agenda in favour of ‘will they/won’t they’ speculation about whether Enda or Micheál will make the first move, and the hairdo of a convicted drug smuggler.
While it’s fallen off the political and media agenda, mental health is still very much on the agenda of two Cork families we spoke to on the Opinion Line last week. And those two, who felt their situations were so desperate that they had to go on radio to get some redress, are just the tip of the iceberg.
Solicitor Ernest Cantillon is a family friend of ‘Marie’, who is one of numerous unfortunate individuals to suffer from a ‘dual diagnosis’, where a person has both an addiction and a psychiatric illness. This isn’t in and of itself a fatal condition, but in Ireland it often is, because our system refuses to acknowledge that people who have addiction problems regularly have some kind of psychiatric condition as well. It’s not rocket science, but the HSE refuses to acknowledge that addictions and mental illnesses go hand in hand. And because of that head in the sand approach, people die.
Marie is currently wandering the streets of Cork city, where her condition is so vulnerable that she has been attacked and raped. Members of her large, loving family spend most days out looking for her. Some days they find her.
They bring her to A&E, where she will drink alcohol based hand sanitiser if it’s all she can get, while they wait. She may be admitted for a night. Almost every time this has happened, Marie has been discharged without a family member present – according to Cantillon, the over-arching respect for the privacy of patients means many vulnerable psychiatric patients are left to their own devices within the health system, to the detriment of their own care – and the family is back on the merry go round.
She won’t be admitted to an addiction counselling facility until her psychiatric illness is treated; and she won’t be given treatment for her psychiatric illness until her addictions are under control. It’s the deadliest Catch 22 there is.
There is no end in sight to this appalling situation beyond the obvious, tragic one. When I spoke to Marie’s sister initially about scheduling an interview, she told me they couldn’t say when was a good time, because any morning they could go looking and find her dead.
Marie’s case echoes almost exactly that of Caoilte O Broin who was found in the Liffey last New Year’s Day. His family had gone public, too. And there was still no help for them.
The organisation Dual Diagnosis Ireland is currently working with Marie’s family and Cantillons Solicitors to try and get help for Marie.
So, while a complex situation like dual diagnosis could perhaps be considered a new challenge for the HSE, anorexia nervosa has been around a while. But it may surprise you to know that there is no specialised care for anorexic patients on the public system. It certainly shocked me.
On Thursday, I spoke to Sharon Hegarty. Her 18 year old daughter Lauree is in CUH at the moment suffering from anorexia. She’s down to just over 5 stone and Sharon has been asked by the team treating Lauree if she’s prepared for her to die.
But there is no specialist in anorexia in CUH. There is no expertise in this area. There is treatment available, in Dublin. It costs €1500 per day. The Hegartys don’t have private health insurance. If they did, it would be covered.
We’ve often heard the health system described as apartheid. But nowhere more than in mental health services is this more apparent. If you can pay, you’ll be cured. If you can’t, prepare for your child to die.
The 1916 rebels may not have heard of dual diagnosis, or anorexia. They wouldn’t have known about the complexities of treating young women so battered by the world that they are slowly destroying their bodies through addiction, abuse or starvation.
But today’s politicians have no excuse not to know. HSE administrators have no excuse for not knowing that people with mental health conditions may have addictions, and anorexics need expert treatment.
Today’s politicians have no excuse for not knowing that one life is no more valuable than another, that just because a family can’t afford VHI or Laya healthcare for their precious child, she doesn’t deserve to live.
If you are affected by any of the issues raised in this article please see dualdiagnosis.ie or bodywhys.ie.
Published in the Evening Echo 14.04.16