Respite services and carers in crisis

Sir, – I would like to echo Prof Seamus Cowman's strong and passionate letter (December 9th) highlighting the current lack of day and respite services for people with intellectual disability and their families, which has become much worse since the Covid -19 pandemic.

Disability day and respite services in many areas are either closed or are not functioning at their previous capacity, which is having a seriously detrimental effect on people with intellectual disability and their families.

As a consultant adult psychiatrist in intellectual disability for the past 28 years, I have seen an increase in depression and anxiety disorders, psychosis, and severe challenging behaviours, including serious assaults, in my patients which is directly related to the curtailment of day and respite services.

Many have parents or siblings who have serious health problems themselves, or in many cases are frail and elderly.


One father told me he has bought locks for every room in his house to keep him safe from his adult disabled son, since the Covid-19 pandemic started.

Another parent spends hours driving his adult son around the city when he is finished work in the evenings to reduce his son’s anxiety and aggression.

For many people with intellectual disability, their entire social lives are based in and around their day services, their friendships, activities, their routine, and many of them cannot understand why it has been taken from them.

Mental health services for people with intellectual disability remain regrettably seriously deficient in Ireland. Covid-19 has exacerbated this.

The development of mental health teams in intellectual disability (MHID) was proposed in the HSE document Vision for Change in 2006 for the first time. This was a very exciting prospect for people with intellectual disability and for their families and the dedicated staff working in this area. Regrettably, many areas and many counties still have no MHID teams, and in addition there are no specialist psychiatric in-patient beds in the entire country for people with intellectual disability.

Progress and development are at a snail’s pace, and that is causing many serious problems to people with disabilities, their families and the very dedicated staff who work in this area, many of whom are at risk of burnout.

Ireland should do better than this. – Yours, etc,


Consultant Adult

Psychiatrist in

Intellectual Disability,