THIS has been a bad year for psychiatry. In January, the High Court found that the North Western Health Board had been negligent in discharging 58 year old Mr Eamonn Healy from St Columba's psychiatric hospital, Sligo. Four days after his discharge Mr Healy committed suicide.

In that same month, a 26 year old Dublin woman, Ms Katherine Dwyer, killed herself two weeks after being discharged from St Loman's Hospital. She had been admitted to St Loman's in December after stabbing her father to death and had discharged herself within days. On Christmas Eve she was admitted to the hospital again following a suicide attempt, but was out in time for her Christmas dinner the next day.

Brendan O'Donnell had contact, on and off, with psychiatrists or psychiatric institutions and was discharged from St Brigid's psychiatric hospital, Ballinasloe, two weeks after being committed following an assault on his sister.

He was discharged without any consultation with his sister or with the GP who committed him and who believed, rightly as it turned out, that he was a danger to anyone he encountered.

Some 25 five years ago it was fashionable to think of psychiatrists as people who were too ready to see mental illness in nonconformist behaviour and to lock people up for long periods of time.

It is arguable that this view was never fair. People spent decades in psychiatric hospitals, not because of a conspiracy by psychiatrists, but because of the demands of a society and of families who wanted them hidden away.

Now, it seems, we have gone full circle. Not only have the days of locking people up for life thankfully passed, but one begins to wonder just what a person has to do to be treated in a psychiatric hospital for any appreciable period of time.

Almost one third of people entering public psychiatric hospitals are discharged in less than a week. By contrast, almost half the patients of private hospitals stay for one to three months, compared with only a fifth of the patients of public hospitals.

Are we to believe that the causes of a crisis of such proportions that it requires a psychiatric admission can be adequately dealt with in such a short space of time? Or are we to believe that these people, discharged after a matter of days, are immediately slotted into a comprehensive, smoothly functioning community system which takes care of their needs?

If that is so, then how do we account for the cases of Katherine Dwyer, Eamonn Healy or Brendan O'Donnell?

This week, The Irish Times heard from the father of a man with a personality disorder whose history of contact with the psychiatric and prison services has been very similar to that of O'Donnell.

The psychiatric service was and is totally inadequate for my son's needs", he said. "If there is care in the community I would dearly like to see where it is. My experience is that they provide a service for those who are sufficiently capable of attending outpatient centres at times and days that suit the staff schedules - hardly helpful to a person who is incapable of such discipline. My request for a psychiatric social worker to keep in contact with my son resulted in one visit."

A woman contacted us about a suicidal friend discharged from a psychiatric hospital in a "desperate" state, with no referral to counselling or other services. Her friends eventually arranged private counselling for her. The psychiatric service appears to have had nothing to offer.

Psychiatry is seen as the Cinderella of the health services.

"There is a serious under provision of in patient adolescent units in Ireland, and nothing at all for young people who need secure therapeutic accommodation", according to Dr Don McDwyer, a psychiatrist, writing in a book on the Child Care Act, On Behalf of the Child.

"The average child psychiatric service sees about 1 per cent of the children in its area", he writes. "This means that our direct impact on the total scale of the problems is very small and that over 90 per cent of children in difficulties will never be seen by us."

It is noticeable that the average length of stay in private hospitals is longer than in public psychiatric hospitals. For instance, a patient's chances of being discharged within days of admission is more than twice as high in a public hospital than in a private psychiatric hospital.

The suspicion has to be that public psychiatry is being driven by the desire of administrators to keep budgets in trim by reducing the number of in patient days at all costs. If that is so, the doctors, nurses and others who operate the psychiatric services would do well to begin to reclaim psychiatry from the accountants.