The local community is not convinced by the 'reshaping' of alcohol treatment services, writes Eithne Donnellan, Health Correspondent.
For years hundreds of people with alcohol addiction in east Galway have been travelling to St Brigid's Psychiatric Hospital in Ballinasloe "to dry out".
A small number of the 300 or so patients admitted for detox every year would then opt for residential group therapy treatment after being discharged from the acute unit. If deemed suitable, they could participate in the programme on the hospital campus and stay in the old nurses' home for four weeks. Participation in the programme was known locally as "doing the unit".
Now, however, the Western Health Board has decided to "reshape" its alcohol treatment services. It has axed the residential programme and said the counsellors will move to the community to bring services closer to clients in line with best practice. The board said the service for addicts will be "enhanced" and counsellors will be available in towns around the county at evenings and weekends.
The local community is not convinced. Over 300 people attended a public meeting in Ballinasloe recently where the move was condemned. Local Oireachtas members were requested to arrange a meeting with the Health Minister, Mr Martin, to discuss their concerns.
Even Bishop John Kirby opposes the decision. He said despite what the health board said he still believed the decision was a retrograde one.
"I think that serious treatment of alcoholism needs a more substantial intervention than is available in drop-in type centres. I think it's a pity they have decided to drop this programme."
He said it was strange, that at a time when Irish people were drinking more than ever, this decision was taken. "The health board genuinely believes the new arrangement of more local counsellors in small towns in the area will provide a better service. While I acknowledge there will be more local counsellors, I still believe a departure from the community to go into a residential unit has a value of its own."
The clinical director of east Galway's mental health services, Dr Kieran Power, who is a consultant psychiatrist at St Brigid's, said referrals to the service had declined. He denied suggestions made locally that the health board had orchestrated fewer referrals so it could close the service.
He said the people attending the residential treatment programme stayed overnight in accommodation which was unsupervised. "This gave grounds for concern for all sorts of reasons.
"We did not have untoward incidents but one was always nervous of the possibility of something happening. It was high risk and the health board would be responsible if something happened," he added.
Mr Liam Curley, a counsellor who was involved in setting up the programme over 20 years ago and who retired last year, asked why was it the health board did not do something about such concerns in the past 20 years.
He rejected the assertion that the addicts' sleeping quarters went unsupervised at night. He said no staff slept in the unit but the night-time nursing superintendent would check it several times a night. He acknowledged that many people with alcohol problems recover with a minimum amount of intervention but said there is "a nucleus" of people who, because of the extent of their denial or other factors, will need a residential programme.
Dr Power said the health board acknowledged this and would make arrangements for those who need a residential programme to be treated privately.
Mr Curley said many of those who used the Ballinasloe unit would have come from socially deprived backgrounds. "So they don't fit in easily with the other programmes that would require a lot of educational work. Our programme was designed for that group and after their four weeks in residential therapy they would be offered a two-year after-care programme.
"I find it unbelievable that the health board can say it is enhancing a service by closing down an element of it," he said.
Dr Power put the disquiet in the area down to "a number of different agendas operating at a mini political level". Only 50 patients a year were partaking in the programme, which had three staff, and there had been only 14 referrals between January and June this year.
Mr Curley said there were alcohol addiction counsellors attending towns around the county for years and that there was nothing new in this. The only development was the three extra counsellors who had been recruited in the past year.
Mr Michael Mullins, a local councillor and health board member, who chaired the Ballinasloe meeting, said the campaign to get the board to row back on its decision would continue.
"It seems amazing that at a time when all the private facilities like the Rutland Centre are full and have waiting lists, a facility for public patients is being discontinued. It emphasises yet again that there is very much a two-tier health system in operation in this country."