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'Most unfortunate case': Central Mental Hospital staff engaged in standoff with gardaí over mentally ill man's admittance

The man was initially refused entry due to the lack of beds in the CMH, an ongoing issue at the Dundrum facility.

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AN “EXTREMELY” MENTALLY ill man being transferred by gardaí to the Central Mental Hospital following a court order last week was denied entry by staff due to a lack of capacity, leading to a “stand-off” at the gates of the south Dublin facility.

The man was ultimately admitted for treatment after several hours, in what his solicitor described as a “most unfortunate case”.

The man appeared before Trim Circuit Court on Friday where, according to his solicitor, expert evidence of a consultant psychiatrist recommended that the man was vulnerable, and in need of immediate psychiatric intervention by way of treatment at the Central Mental Hospital.

Solicitor Ciarán Mulholland said everyone in the court was of the view that the individual required immediate attention from the CMH “particularly given the circumstances whereby he was held in custody for over a year waiting for a bed”.

“It was for his own safety, the safety of others, but also conscious that the prison service is not the facility to deal with ill patients of this nature,” Mulholland told Today with Claire Byrne, adding that the man was “deteriorating badly”.

A court order was subsequently issued and gardaí brought the man to the CMH in Dundrum where they were unable to gain entry on Friday afternoon.

Mulholland said he was in contact with gardaí after the hearing about his client and was surprised when he was told by gardaí that the CMH was not in a position to take this individual, resulting in a “standoff”.

Mulholland understands that gardaí gained entry to the premises when there was a change of staff at around 7pm, after initial negotiations were “unfruitful” earlier in the day, as outlined in the Irish Times which originally broke the story this morning. 

In relation to this incident, gardaí said they were acting on the instruction of a court order.

“On Friday 19 March following a court order at Trim Circuit Court issued by the sitting Judge, Gardaí brought a man to Dundrum Central Mental Hospital on the instruction of a court order,” a garda spokesperson said. 

The HSE confirmed that the CMH is currently operating at 100% bed occupancy, and that it is working to make every effort “to meet our statutory obligations at this time”.

“Admissions for the limited number forensic inpatient beds are systematically triaged according to the level of therapeutic security required and the urgency of that need,” a spokesperson for the HSE said. 

“The capacity for patients in the National Forensic Mental Health Service will increase following the move from the Central Mental Hospital to the new 170 bed facility in Portrane which is due to open in mid-2021.” 

‘Matter of extreme urgency’

Mulholland said that gardaí and CMH staff are “trying their best” but that there are an “array of systemic flaws” that have not been addressed by consecutive governments.

“It’s action that is required because the most vulnerable in Irish society, and the most marginalised, are sitting in custody at the moment. A significant proportion of them really should be in a medical institution receiving the requisite treatment,” said Mulholland. 

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From his own experience, Mulholland said the situation is getting worse and estimates that at least 20% of his clients, particularly the re-offenders, are very unwell individuals that should not be before the criminal justice system, “they need medical treatment”.

There’s a lot of people in the prison population that are constantly coming back into the system, and what they need is not the criminal justice system they need is an equipped and compassionate health system.

The recently published 2019 Annual Report of the Office of the Inspector of Prisons highlights a number of issues in prisons in Ireland, including the treatment of mentally ill prisoners which it states “must be addressed as a matter of extreme urgency”.

  • Read more here on how you can support a major Noteworthy project to examine the level of overcrowding, medical treatment and access to resources in jails.

“As a State, Ireland is currently not meeting its obligations to ensure adequate healthcare provision for mentally ill prisoners who are not receiving the treatment they require,” the report notes.

Many of these prisoners are accommodated on an extremely restricted daily regime. While the Inspectorate understands that limited out-of-cell time is a measure imposed to ensure the safety needs of mentally ill prisoners and others in the prison, these restrictions amount to inhuman and degrading treatment. The treatment of mentally ill prisoners must be addressed as a matter of extreme urgency.

The Irish Penal Reform Trust (IPRT) is calling for the Annual Report for 2020 to be published without delay by the Department of Justice as the 2019 report does not detail the challenges Covid-19 restrictions have posed in prisons over the past year.

“One of the biggest failures of the State in terms of caring for the most vulnerable is the continued practice of incarcerating people with severe mental illness in prison because of a lack of access to community hospitals or space in the Central Mental Hospital,” an IPRT report from January said in relation to the progress made in addressing mental health in the Irish prison system.

“In any given month through the first half of 2020, there were anything from 21-33 very unwell people incarcerated,” the report notes. 

“If we are to learn anything from Ireland’s history of inappropriate institutionalisation of our citizens, incarceration as an alternative to healthcare must end. The solution is one that requires leadership at all levels in the State, but operationally, the Department of Health must work hand-in-hand with the Department of Justice to end this practice.”

 

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Adam Daly

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