A “significant” proportion of people who committed crimes while in active psychosis or while struggling with mental illness sought help from the health services in advance of their actions, a leading psychiatrist has said.
Prof Conor O’Neill, a consultant psychiatrist who leads a diversion programme at Cloverhill Prison, said tragic incidents usually occur in the case of someone with an “established illness for a number of years”.
“They can stay well most of the time, but when you stop your meds and disengage,” that can change, “particularly if there are some substances in the mix,” he said.
“And the cycle repeats, sometimes with tragic outcomes, more commonly for the individual themselves, but sometimes for the people that are closest to them.”
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Prof O’Neill said: “So a significant proportion of these people will be brought in [to hospital]. Often this is by the police. But there are hardly any beds if you need to be admitted. The sicker you are, the harder it is to get help.”
Earlier this year, Diego Costa Silva, who cut his wife’s head off in November 2021 while suffering from a cannabis-induced psychosis, was found not guilty of her murder by reason of insanity. During his trial the jury heard Costa Silva, from Charlestown Place, Finglas, Dublin 11, displayed a paranoid belief his wife might hurt him, resulting in doctors at the Mater hospital asking the defendant to remain as a voluntary patient. He chose to leave the day before the killing.
Adam Nolan, with an address at Buirg an Rí Walk, Balgaddy, Lucan, Co Dublin, killed his mother’s partner two weeks after being sent home from a hospital emergency department, where he had gone because he felt he “had to kill” him.
In 2017 Gerard Dowling, of The Sycamores, Freshford Road, Kilkenny, had paranoid schizophrenia and went to a psychiatric unit in St Luke’s Hospital, Kilkenny because he was feeling paranoid and hearing voices. He didn’t get to see anyone and left; just hours later he stabbed a stranger in the head with a knife.
Moire Bergin, with an address at Seville Place, Dublin 1, was found not guilty by reason of insanity for the murder of her mother. She had a diagnosis of bipolar affective disorder with symptoms of mania, depression and psychosis. She had been admitted to hospital six times over the year leading up to the murder; on each occasion, she had been manic, psychotic and wandering the streets naked. She was last released five days before the killing.
One source working within the system said prisons are “littered with people who have sought help”, but “we [the State] don’t have beds to put the guys into”.
A spokeswoman for the HSE said at the end of last year, there were 2,666 registered inpatient psychiatric beds, of which 69 per cent were HSE-run. There were also 114 operational National Forensic Mental Health Service (NFMHS) and 91 mental health intellectual disability (MHID) beds.
“Sharing the Vision, Ireland’s national mental health policy, aims to create a mental health system that addresses the needs of the population through a focus on the requirements of the individual,” the spokeswoman said. “This mental health system should deliver a range of integrated activities to promote positive mental health in the community; it should intervene early when problems develop; and it should enhance the inclusion and recovery of people who have complex mental health difficulties.”
The spokeswoman said that if someone is experiencing a mental health crisis, there are a number of routes to obtaining help and support, including GPs, hospital emergency departments, suicide crisis assessment nurses and community mental health teams.
Supported by the Rosalynn Carter Fellowship for Mental Health Journalism in the Republic of Ireland in partnership with Headline, a Shine programme.
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