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Mental health services failing vulnerable, warns sister of patient held in jail

Ireland has one of the highest levels of severe mental illness compared to its European counterparts.

Joseph Fay on a trolley as the family awaited a mental health bed for him last year.
Joseph Fay on a trolley as the family awaited a mental health bed for him last year.
Image: PA/Family Handout

THE SISTER OF a mentally ill man who has been kept on a prison sick ward for more than three years due to a lack of available beds says the health service is failing the most vulnerable.

Sandra Fay’s brother Joseph, 46, developed manic depression and schizophrenia after the death of another sibling when he was 18, and she said putting innocent, vulnerable people into a prison should be “unthinkable” in today’s society.

Ireland has one of the highest levels of severe mental illness compared to its European counterparts, yet has fewer adult psychiatric beds than almost any other country.

According to an OECD report, 18.5% of the population was recorded as having a mental health disorder such as anxiety, bipolar, schizophrenia, depression, or alcohol or drug use, in 2016.

The practice of using prisons to house mentally ill patients has increased in recent years, according to patient advocates.

It emerged last year that 26 severely mentally ill patients deemed to be a danger to themselves and others were being kept in prisons due to a shortage of beds at the Central Mental Hospital.

Mr Fay, from Tallaght in Dublin, has been in and out of the prison system for three years after beds in adult mental health services became scarcer, and most recently he stayed in Cloverhill Prison from April to October.

His sister said: “His mania and paranoia means he becomes very aggressive towards the family, especially my mum as he believes she’s kidnapped him, and it’s not safe for her and him in the house.

“When we first accessed services, it was never a case of you couldn’t get a bed, or moving him on to make space.

“Nowadays, we’re in a situation where overworked doctors are trying to make space in overcrowded facilities.

“What’s happening increasingly is when the doctor arrives, he says Joseph, when he’s completely manic and highly delusional, is fine.

“The only reason they can be saying he’s fine is they’re under pressure knowing there’s nowhere to put him.”

Garda advice

Officers advised Ms Fay’s mother to take out a barring order against her son for her own safety, which means they can take him to a prison unit where he can be kept and supervised.

But Ms Fay said there are not enough appropriately-trained staff to care for someone with Joseph’s condition, and while he was in Cloverhill he received a stomach injury which appeared to be scalding.

She said: “He was really agitated in Cloverhill, he felt trapped.

“For my mum, she’s 70 now and it’s devastating for her, Joseph has always come first in our house.

“She keeps asking to have him back, but 20 of my mother couldn’t take care of him, she feels such guilt and failure, but it’s not her fault.

“You don’t know what’s happening to them, you’re not privy to know about their care, you can’t visit, they’re in prison despite their illness.

“Joseph’s age has retracted from the illness, he behaves very childlike, a man in an adult body, schizophrenic, and there are no facilities across Ireland that cater for him long-term, so the solution is to put him into a homeless shelter, or on to the streets where he has no idea of danger.

“I have nothing but admiration for the staff, these doctors and nurses are put in an impossible situation, but as long as there are waiting lists for mental health services, there are no mental health services.”

The HSE concedes there is “ongoing capacity pressure” on acute beds, which are prioritised based on clinical need.

A spokeswoman said: “Due to a high demand for the limited number forensic inpatient beds, admissions are systematically triaged according to the level of therapeutic security required and the urgency of that need.

“Where feasible and appropriate, prisoners with mental health needs are seen by their local acute mental health facility or community mental health team.

“If a prisoner requires admission to the Central Mental Hospital, a referral is made which is based on clinical need.”

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