State can find no suitable place for a handicapped 18-year-old

This week the newspapers and the television were full of the happy faces of young people getting their Leaving Certificate results. As they passed through one phase in their lives and entered another, most of them could feel the State was doing its best to ease the transition. For any of them who wanted to go on to third-level education, the State can now virtually guarantee a college place.

Yet, while their parents were reflecting with satisfaction on these happy prospects, Cathleen O'Neill was desperately trying to draw attention to one school-leaver for whom the State had no place at all.

For many years now, she has been trying to repair broken lives. She has been central to some of the most universally admired social projects in Dublin, KLEAR in Kilbarrack and Saol in the north inner city, using education as a ladder for women drug addicts to climb out of despair and powerlessness. She has written brilliantly and passionately about powerless people.

Yet, in the last few months, Cathleen O'Neill has herself been hard put to avoid those same feelings of despair. This week, she had to gather all her strength and literally camp out in front of the headquarters of the Eastern Health Shared Services at Dr Steevens's Hospital. And all to achieve something that should be taken for granted in any civilised society, let alone one of Europe's economic success stories.

Cathleen O'Neill's 18-year-old son Sean is a citizen of this republic. He is also a fine young man, tall, strong and handsome. He loves reading, listening to music, hearing stories, working in the garden. The fact that he suffered a brain injury at birth and that he has autism and a moderate mental handicap doesn't make his parents feel any less proud of his achievements than thousands of other parents when their sons and daughters got their Leaving Cert results this week.

But while the Minister for Education, Dr Woods, was this week assuring those young people that the State could provide a place for every one of them to further their education if they wished, the best this State could offer Sean O'Neill was a place in a mental hospital, St Ita's in Portrane.

For at least three years now, the authorities have known that, as of June 2000, Sean O'Neill would need a place in an institution appropriate to his skills, his condition and his future development as a valued citizen. He spent the last 12 years in just such a place - a Camphill Community in Northern Ireland where he was able to grow and learn and be happy. The Camphill Communities look after children, however, and it was always clear that Sean would have to leave when he was 18. So, after Sean turned 15, Cathleen launched a flurry of contacts with the responsible agencies to ensure that, when the time came, he would have a suitable place to go.

Yet, when the time came, there was nowhere. The plan was for Sean to go to the Irish Autism Centre's facility in Dunfirth, Co Meath. After he left the Camphill Community, however, it became clear that there was in fact no place for him at Dunfirth.

Sean was given temporary day care in Gheel House in Fairview, Dublin. But that could only be provided until this week. After frantic contacts with the Eastern Regional Health Authority, the best offer the State could come up with for a young citizen like Sean O'Neill was a bed in a ward in a mental hospital.

That hospital, St Ita's, has itself been the subject of a long, brave campaign by another remarkable woman, Anne Ryan, who had to stage a dramatic protest to draw attention to the very poor conditions there many years ago. St Ita's, which has over 280 patients, many of them in locked wards, was most recently in the news when it was revealed that its water supply was contaminated with E.coli. It has been the subject of repeated criticism from the Inspector of Mental Hospitals. Though there is a long-term plan to transform the institution, the National Association for the Mentally Handicapped of Ireland estimates that, at the current rate of progress in its implementation, the plan will not be completed for another 10 years.

In any case St Ita's is entirely unsuitable for people with mental disabilities. Sean O'Neill is not mentally ill and doesn't need psychiatric care. He needs a safe, active, caring environment where he can further his education just like any other 18-year-old coming out of school. No one believes that St Ita's can give him this. He would be sent there purely and solely because the State has nowhere else for him to go.

Yet, after Tuesday night, when Cathleen O'Neill and her supporters camped out in front of the EHSS headquarters, it suddenly emerged that something can be done for Sean O'Neill after all. In the wake of the high-profile protest, three different offers were made. None was ideal, but all were infinitely better than a mental hospital. One, Sunbeam House in Co Wicklow, offers a reasonably satisfactory prospect for Sean. While, says Cathleen, "it's never going to be what he needs", it will provide a loving and safe environment in which he will have the chance of a decent life.

Yet Cathleen O'Neill's relief is tempered by the uneasy feeling that what she has achieved for Sean is both an absolutely basic right and a bitter kind of privilege. She had the strength, the skills and the contacts to mount a campaign, make a lot of noise and turn Sean's plight into a public embarrassment for the State. But the treatment of Sean O'Neill is by no means unique. Had he been forced into St Ita's, he would have been just one of about 1,200 people in similar circumstances.

According to Mr Gerry Ryan of NAMHI, which enthusiastically supported Cathleen's campaign, there is a "steady trickle of people like Sean" with autism and other mental disabilities ending up in St Ita's purely because they have nowhere else to go. The same is true of other mental hospitals, some of which now have separate, so-called "de-designated" units specially for people with mental handicaps. Because these units are officially not part of the mental hospital services, they are not even subject to scrutiny by the Inspector of Mental Hospitals.

Overall, figures published by the Department of Health last September show that suitable places will have to be found by 2004 for 3,380 people like Sean O'Neill who have intellectual disabilities or mental handicaps. Some of these people are currently in schools and homes that provide only for adults and will be leaving those places over the period. Others are currently in utterly unsuitable accommodation such as mental hospitals. The Government parties, in their Action Programme for the Millennium, promised "radical change to ensure that the needs and aspirations of people with disabilities, their families, carers and advocates are comprehensively addressed".

For people like Sean O'Neill, though, most of the radical changes in their lives continue to be changes for the worse.