asked the Minister for Health whether his attention has been drawn to a statement of Dr. O'Brien, Governor of the Central Mental Hospital, Dundrum, Dublin, that during her long psychiatric career she had never sent a patient to Dundrum and that, following her recent three years as Governor at Dundrum, she was satisfied that she was correct in adopting such a policy; and whether he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Statement of Governor of Central Mental Hospital.
33.
Patients are transferred from district mental hospitals to the Central Mental Hospital under section 207 of the Mental Treatment Act, 1945. Action under this section is initiated by the psychiatrist in charge of the particular patient. This section provides, briefly, that if a person detained in a district mental hospital is charged before a justice of a district court, sitting in the district mental hospital, with an indictable offence, and evidence is given which satisfies the justice that the person committed the offence but would be unfit to plead if placed on trial, the justice shall certify that the person is suitable for transfer to the Central Mental Hospital. The Minister for Health then requires the Inspector of Mental Hospitals to report on the patient and, after consideration of his report, may direct the transfer of the patient to the district mental hospital.
The number of persons dealt with under section 207 is limited and the question of whether a particular psychiatrist was involved with the transfer of patients under the section depended partly on whether the required circumstances arose in a particular place and partly on whether the psychiatrist thought it was necessary or desirable to have proceedings initiated under section 207.
The Commission on Mental Illness was satisfied that it was essential to maintain a procedure for the transfer from district mental hospitals to the Central Mental Hospital of patients who are very violent or homicidal.
34.
asked the Minister for Health who are the persons referred to by Dr. O'Brien, Governor of the Central Mental Hospital, Dundrum, Dublin, when she said that there are young persons in that hospital who should not be there.
I understand that Dr. O'Brien had in mind persons who had committed or had been charged with minor offences and that she felt they could suitably be dealt with in the district mental hospitals. I am afraid that Dr. O'Brien's views on this matter are not shared by most of her colleagues. Patients who are under sentence or on remand have to be detained with a resonable degree of security. It is very difficult to provide this security in most district mental hospitals. In accordance with modern concepts on the care of psychiatric patients these hospitals have few, if any, locked wards and such wards may be completely unsuitable from a therapeutic point of view for the patients referred to by Dr. O'Brien.
Can the Minister explain how he is prepared to accept Dr. O'Brien's decision in one set of circumstances and reject it in another set of circumstances?
There is quite a wide variety of views in regard to psychiatric illness. The Deputy should know much more about that than I do but I have read enough in general on the subject to know that views on various types of mental illness and the treatment therefor are not universally accepted by everybody and there can be controversy but I can assure the Deputy that Dr. O'Brien is a competent person and my Assistant Inspector and inspectors of my Department have frequently reviewed her decisions and have found nothing wrong with them and so although she may hold views of her own of a comparatively strong character on the matters referred to by the Deputy I have no reason to suspect that she does not exercise wise judgment in her recommendations in regard to patients.
Is it not clearly established by everybody, including the Minister and the Commission and his own inspector, Dr. Campbell, that there are no remedial, psychiatric facilities available in Dundrum? No reflection whatever on the existing staff, they simply have not got the facilities. Why then is the Minister so indifferent to the reality that there are a number of people there who could be perfectly peaceful, not violent people, who could be held in district mental hospitals and, what is much more important, given remedial psychiatric care? Surely the Minister may not remain indifferent to these people? If they were relations of his own, surely he would not treat them in this way?
No, I have tried to make the position perfectly clear to the Deputy. I am satisfied from the observations of the psychiatric inspectors of my Department that the position is reasonably good and that there is nothing about which I should have extreme momentary anxiety. I have also said that when the Central Mental Hospital is linked and integrated with the Eastern Health Board mental hospitals the position can be improved. The two statements are not inconsistent.
35.
asked the Minister for Health what steps he proposes to take to enforce segregation of young from older patients at the Central Mental Hospital, Dundrum, Dublin as recommended by the Governor, Dr. O'Brien, and in particular in the case of one young man (name supplied) who is held in the infirmary.
I am advised that the complete segregation of young from older patients is not necessarily a therapeutic requirement and that contacts between them can be of benefit to both types of patient. In the case of the patient, whose name was conveyed to me by the Deputy, I am advised that, in the opinion of the Governor of the Central Mental Hospital and of the Assistant Inspector of Mental Hospitals, it is desirable, in the interests of the physical and mental condition of the patient, that he should be cared for in the infirmary but this does not prevent his participation in other recreational or therapeutic activities in the institution.
Could the Minister give me any explanation as to why he referred to the Assistant Inspector of Mental Hospitals in this case?
Because it was the Assistant Inspector of Mental Hospitals who undertook the inspection.
Question No. 36.
Can the Minister say why he chose the Assistant Inspector in this case and the Inspector in the other case?
Because I thought it was more suitable in this particular case.
For what reason, Sir?
For reasons that I am not prepared to state in the Dáil. It would be unfair.