Psychiatry In Ireland

 

Sir, - For too long psychiatry has been the Cinderella of the Irish health services. In reality, it bears closer resemblance to the ugly sisters of the fairy tale. The current debate regarding the neglect of psychiatric services in this country is therefore timely. Vincent Browne has done some service in bringing to public attention the issues highlighted by the recent report of the inspector of mental hospitals.

In such a neglected service it is often difficult to see that substantial advances have been made over the past 20 years of modern psychiatry. The professional divisions of the past have been healed. Genuine measurable psychotherapies have been described and a new era of effective, non-stigmatising drug therapies has been introduced. The synergistic benefits of combining these humane treatments in the least restrictive environment is universally accepted.

Unfortunately, the psychiatric service in Ireland falls far short of delivering these advances reliably and uniformly. The treatments described above require adequate numbers of trained professional staff working together in teams. Many areas of our service limp along with minimum numbers of temporary medical and nursing staff, often working alone. Regular, structured input from psychology, behavioural and cognitive psychotherapy, occupational therapy and psychiatric social work, is essential to achieve modern results. The inpatient and out-patient buildings used by our service are acknowledged as unsuitable and inappropriate. Basic sanitary facilities are often rudimentary, with little regard for the dignity of vulnerable men and women.

Psychiatry needs investment in personnel and capital. There is an urgent need to set standards of care and to provide resources to meet those standards. This can be done. Modern effective treatments have transformed the legitimate expectations of the public and their carers. With proper resources psychiatry can lead to an outcome worthy of any Cinderella. Without resources it will remain the ugly sister of the health service. - Yours, etc.,

James V. Lucey, MD, FRCPI, MRCPsych., EHB Consultant Psychiatrist, James Connolly Memorial Hospital, Blanchardstown, Dublin 15.