I am surprised to hear that the number of people in the Central Mental Hospital is so high. I understood that it tended to drop over the years. I am interested in the matter because I think I was responsible for changing the name of this place from the Criminal Lunatic Asylum to the Central Mental Hospital. My attitude was to regard the person called a criminal as a sick person requiring care in a hospital and, therefore. I felt this was the more appropriate designation for the place. Obviously, that is a point about which there could be great argument and I do not want to go into it now.
If the hospital is so fully occupied with a complement of 135, how does that fit in with the recommendations of the commission in regard to its use for the different kinds of person we cannot carry in the general psychiatric hospital, particularly the aggressive psychopath, the non-aggressive psychopath, the drug addict, the alcoholic, and the very difficult people to handle, the homicidal type of seriously ill person? Whatever may be said about the adult psychiatric problem—and I hope to say a lot more about it on the Estimate —at least there are facilities of a kind available varying in degree from very good in a few places to very bad in others, but the problem of the use of the Central Mental Hospital as a high security unit for the care of the young psychopath, the juvenile delinquent, the difficult young adolescent is a very difficult one. The Minister may recall I asked a question about the appointment of a director to take over this whole problem.
Probation officers, the Garda, the judiciary, the legal profession and clergymen do their best to deal with the problem but nobody seems to have found any solution at all in regard to the difficult adolescent, the juvenile delinquent, the young criminal psychopath or whatever name you put on him. This is a matter of very grave urgency. Everybody passes them on. The courts send them to us. We send them to St. Patrick's. They then send them out to an establishment on the Bray Road and they probably end up in Mountjoy. Mainly we tend to pass them from one to the other and nobody is really treating this problem at all. We hoped some action would be taken to convert this hospital into an establishment for the care of this kind of patient. That is why I feel there is a great urgency about this question of the appointment of a director of forensic psychiatry.
The Minister may remember I asked him about this. I happen to know that the person they have in mind is a particularly talented person, a particularly suitable person. Most of us in ordinary general psychiatry are more than anxious that a person of this calibre should come into the service in Dublin and take over this whole question of the difficult problem of the adolescent who finds himself in trouble with the courts and the police. At the moment such a person is really getting no treatment at all. We also hoped that this centre could be used for research into this terrible problem in respect of which no psychiatrist will say he has the answer. I think there is one in Copenhagen, Denmark, that goes nearer to trying to deal with this problem, but most people are prepared to admit there is very little which can be done for a number of those people. Something can be done for some of them but very little for many of them. There is an urgent need for the establishment of this unit. I think the Minister knows that the recommendation was that it should be based on the Central Mental Hospital in Dundrum.
That will require a great increase in the staff. This highly skilled staff are very difficult to find. In the whole sphere of medicine there is no one more difficult to treat, with the exception possibly of the drug addict, than the young psychopath. Most people are prepared to concede that point, both from the medical and nursing point of view. I do not know whether the Minister has had time to consider this problem. I can assure him it is a problem of great urgency. If possible the Minister should try to secure the high-quality type of individual whom I believe is available. The Minister should do everything in his power to get such people in order that a service could be established for these very pathetic, sad youngsters. They create great anger among the public and the community generally when they go around smashing things and sticking knives in one another or taking drugs and indulging in various sexual perversions or alcoholism. They make the community very angry indeed. That is one of the problems in treating them. Even a trained therapist finds it difficult not to get angry with them. These patients are essentially very pathetic people who need help very badly. We do not give them such help. There is no separate service for them in Dublin. We lock them up in St. Patrick's, in Mountjoy or in the new establishment on the Bray Road. We have not provided a service or the personnel to deal with them. I would be glad to know what the Minister has in mind in this regard.
I can assure the Minister that many people have come to us asking for help. They have come from all sectors of society—the Judiciary, the Garda and the other groups previously mentioned. The general psychiatrists are most anxious to have this matter dealt with most urgently. These young people tend to drug addiction, alcoholism, male prostitution and criminality of one kind or another. The position with regard to the young girls is similar. It is sad and tragic. I would be very grateful to the Minister if he would look into this matter. There is no problem about which we, in the general psychiatric service, feel more impotent. I have raised it now because the Vote is in respect of this particular hospital which I understand to be the base. There is great need for skilled psychiatric and social workers of various kinds. Above all, there is need for a key individual to set up this service to deal with this very serious problem in Dublin. We tend to ignore the existence of the problem. The Minister would be greatly shocked if he knew the number of youngsters who require help of a very highly-skilled type. We are not giving them such help. Because we fail to give them help they go from bad to worse and end up as recidivists, continually returning to prison. They become the enemies of society—society hating them and they hating society. We have no objection to the Estimate.
