An Unhealthy State


Sir, - Your perceptive medical correspondent, Dr Muiris Houston, is wrong when he asserts that psychiatric patients receive less than adequate care when they leave hospital (The Irish Times, October 4th). It may be so in Dublin and perhaps in other conurbations but this is certainly not the case in west Donegal. Where are the homeless, psychiatrically ill patients wandering the roads of the Rosses or Gweedore?

In the 1940s and 1950s there were 800 patients in St Conal's Hospital in Letterkenny; now there are 80. The proportion of mentally ill people has probably not altered greatly in the intervening decades, but their care in this community has improved beyond measure. Incarceration has been replaced by integration. Mental handicap has been distinguished from illness and resources have been appropriately directed.

Here in west Donegal, sheltered accommodation, day centres and workshops are the norm. Consultant psychiatric services are regular and frequent. The community psychiatric nurse knows his clients well, visits them regularly and is a friend as well as a professional resource to them. Access to counselling is readily available and general medical practice is supported by an integrated and effective matrix of care.

I know that Dr Houston did not intend to suggest that the problems of the psychiatric health services in Dublin reflected the national reality; certainly from my perspective as a country GP, his gloomy views have no local validity. - Yours, etc.,

Declan Bonar, Dungloe, Co Donegal.