Focus on institutionalised people at risk


Sir, – Globally, and in Ireland, there is a focus on Covid-19 infected patients, frontline staff responders, and the risk population, in particularly elderly people with chronic heart and respiratory disease. The recent finding of clusters of infected people in our nursing-home sector is a new challenge and it also serves to demonstrate that there are other populations of people at risk.

Some of our most vulnerable people are our mentally ill and persons with intellectual disability. There are 2,324 psychiatric in-patient residents and over 66.000 people with intellectual disability, with over 2,000 resident in an institution. We have not heard any national discussion about these sectors of healthcare and, given the challenges presented in managing and caring for these populations, frontline staff must be extremely anxious. An outbreak of Corona-19 infection among institutionalised mentally ill or intellectually disabled will present unprecedented challenges given the institutional infrastructures and safety considerations in obtaining patient compliance. How will social distancing and handwashing be enforced, and what criteria will be used in the event of a person requiring general hospital or intensive care?

Psychiatric and intellectually disability services have always been the Cinderella areas of healthcare in terms of budgeting, infrastructure, and staffing, and it is important that this crisis does not affect the provision of appropriate and equitable services for people with mental illness and intellectual disability in Ireland. – Yours, etc,


(Professor Emeritus,


Royal College of Surgeons

in Ireland),


Dublin 15.