asked the Minister for Health whether he is aware that there is considerable public disquiet over the existent conditions in Dundrum Asylum, more particularly in respect of the lack of any mental treatment for patients, lack of segregation of patients with different afflictions, lack of any trained nurses or attendants in the sick bay or elsewhere in the asylum, and general lack of cleanliness and ordinary observance of hygienic standards; further, whether he is aware that there is an urgent need for the appointment of a competent visiting committee and whether he proposes to appoint such a committee and seek any necessary new powers for such appointment from the Dáil before it adjourns this session; and finally if he will state whether in the absence of such a visiting committee the Minister remained unaware of the circumstances surrounding the death of a patient on whom an inquest was recently held.
Ceisteanna—Questions. Oral Answers. - Dundrum Asylum.
I am not aware that the position is as stated. I have taken a special interest in this institution, as indeed in other institutions for which I am responsible, and on the occasion of a recent visit I investigated personally the conditions under which patients are detained.
As regards mental treatment, psychotherapy, with sedation where necessary, and occupational therapy are applied in appropriate cases. Occupational therapy is mainly confined to farm and garden work in the case of male patients. I am considering proposals for the appointment of a visiting dentist and for the provision of neurosurgical facilities. I am also arranging for the establishment of a department of handicrafts which it should be possible to develop in consequence of the increasing availability of materials. Owing to the type of patient in the institution, very great care has, however, to be exercised in the selection of patients for occupational therapy and the supply to them of instruments, which might be used as weapons should they become violent. In addition, I hope to provide improved recreational facilities in the form of film shows at an early date.
There is an infirmary ward on the male and female side of the asylum, and adaquate segregation is provided. All patients who are ill cannot, of course, be nursed in these wards, as some may be violent and destructive, and in that case they are nursed in single rooms. I have no reason to believe that the attention they receive is not as good as they would receive in any mental hospital. The governor has authority which he does not hesitate to use to call in a surgeon or physician to advise on treatment, and where necessary patients are sent to general hospitals for operative treatment. A limited number of the staff are qualified mental nurses, or are in course of qualifying. As a result of my visit, I gathered that a high standard of cleanliness is maintained. I am not satisfied at the moment that there is a need for a visiting committee. The institution is regularly inspected by one of the medical inspectors of my Department.
I was duly notified by the acting governor of the asylum of the death of the patient referred to by the Deputy, and, in accordance with the usual practice, I shall cause an inquiry on oath to be held into the circumstances.
Will the Minister say what is the exact form of segregation now between the violently insane and those who are practically sane?
The Deputy will appreciate that it is not possible to divide the inmates of this asylum into the violently insane and the purely sane. There are various gradations between the two where that has to be taken into consideration. The acutely maniacal must be isolated completely because it is obvious that it would be quite impossible for anybody to be in contact with them at all. It would be impossible to make gradations between acute mania and the patient who might be called sane or to separate them into various categories. I am afraid that certain of the cases who are included in this hospital are saner than others, but it would be quite impossible to divide them and place them in all the different gradations there are.
Is the Minister aware that the only gradation in this hospital is two cages?
I have seen these places and I would not describe them as cages.