Madam, – The absence of any response to the letter from Dr Mark Roe (August 29th) is unsurprising. Although he described a deplorable situation (the official designation in the 1980s of parts of psychiatric hospitals dealing with people with an intellectual disability as “the community”) it usually takes an acute episode of catastrophic proportions to attract national attention. Fortunately these are now rare in the case of the majority of people with intellectual disability because of significant improvements over the past few decades.
During the same period, however, the needs of a substantial minority, ie those with additional mental health problems, have been largely ignored. The reasons for this are historical and complex. A significant factor has been denial at many levels. An over reliance on “community living” as a panacea has not been helpful.
The State of Massachusetts in the US, which has demographic similarities to Ireland, witnessed great enthusiasm for de-institutionalisation and inclusion very early on. However, a colleague in Worcester reports that the state government is building an entirely new public psychiatric hospital. This is now under construction and will accommodate 320 patients in single rooms at a cost of over $300 million. The new Worcester Psychiatric Hospital will be the most expensive public building ever erected in Massachusetts. This is no mean achievement in a country often criticised on this side of the pond for its lack of commitment to public health.
Perhaps there are lessons to be learned from this initiative for our own faltering mental health policy? – Yours, etc,