Inquiry into possible drug-related psychiatric deaths urged

An immediate investigation into an increase in possible drug-related deaths in psychiatric hospitals was urgently required, the director of one of the State's largest voluntary mental health bodies has said.

Ms Orla O'Neill, of Schizophrenia Ireland, was responding to publication this week of the Inspector of Mental Hospitals' Report 1999 which highlights, for a second consecutive year, an increase in the number of possible drug-related sudden deaths in the State's mental hospitals.

"I have to say that I think it's absolutely shocking that this is being allowed to continue without a massive public outcry," she said. "It's as if because they are mentally ill patients it is reasonable not to take a blind bit of notice."

The 1999 report, by Dr Dermot Walsh, says it has been known for a long time that people suffering from psychiatric illness have a higher mortality and poorer life expectation than the general population.

It includes among the causes of "sudden deaths", suicide and deaths believed to be drug related. Both of these "have increased in this country in recent years", it says.

Ms O'Neill said the higher incidence of sudden deaths among psychiatric patients was due to a number of causes. She drew attention to the number of patients taking numerous medications simultaneously whose prescriptions were not frequently reviewed. The result, she said, was that some patients could be on high doses of medication when it was no longer appropriate.

The report comments: "Drug prescribing in some locations is often arbitrary and made without regard to appropriate clinical diagnosis."

It goes on: "The number of patients, particularly long-stay patients who are on numerous drugs simultaneously, often at high doses, was striking. In some instances the prescriptions had not been reviewed for some considerable time . . . There appeared to be an increasing number of sudden deaths in psychiatric hospitals, some of which were attributed to drug-related effects."

There were 30 sudden deaths among psychiatric patients last year, 16 of which were identified as suicides, it says.

Dr Walsh said yesterday that a higher incidence of sudden deaths among psychiatric patients was universal.

"Now, whether that is due to the fact that as psychiatric patients their life expectancy is lower, or because of other factors, remains unexplained and largely unexplainable," he said. "There is an extensive literature on the subject. All cases of sudden death are reported to the coroner and are investigated, in recent years particularly exhaustively."

Asked whether the length of time some psychiatric patients spent on high doses of medication could be a factor, he said that there was "certainly a concern that prescriptions should be reviewed more frequently", but he stressed that no "cause and effect" conclusion should be drawn from this.

Ms O'Neill said any investigation should be carried out by the Department of Health in the first instance. Schizophrenia Ireland provides information and support to families of sufferers as well as campaigning for the rights of sufferers and their families.