There is an atavism at the core of our society which impels a barbarity in the treatment of vulnerable people, among them refugees and asylum-seekers, prisoners, drug addicts and patients of mental institutions. It would be easy to attach this malevolence to a particular political party or to the present Government or to an individual Minister. But it goes beyond that.
For such treatment could not be inflicted on refugees, the mentally ill and prisoners without the complicity of large numbers of people and the bigotry of much of the public.
As noted here last week, the report of the Inspector for Mental Hospitals for 1998, published on Friday, November 5th, said:
"The Inspectorate felt drug-prescribing in some locations is often arbitrary and made without regard to appropriate clinical diagnosis. The number of patients, particularly long-stay patients, who are on numerous drugs simultaneously, often at high dosages, was striking. It is important to review medications at frequent intervals. There appeared to be an increasing number of sudden deaths in psychiatric hospitals, some of which were attributed to drug-related effects."
The clear suggestion is that long-term patients have died suddenly in the last few years because of the gross negligence of medical personnel in mental institutions. The inspector's comment implies that very serious crimes, either manslaughter or criminal negligence, may have been committed.
Involuntary manslaughter arises where a person doing a lawful act behaves so negligently (to the point of being reckless as to the consequence of the act) as to cause the death of another person. Criminal negligence arises where there is "in a high degree the risk or likelihood of substantial personal injury to others".
Since that report was published 12 days ago the Department of Health has begun no inquiry, official or otherwise, into the basis for the inspector's statement. None of the medical professional bodies has expressed a tremor of concern. The Opposition parties, transfixed by what they regard as a real crisis (the failure of a meat company owned by a TD to pay its debts to farmers), have not noticed.
The Minister for Justice, the man who promised us "zero tolerance" of criminality, has been too distracted by the national emergency caused by Northern Ireland taxi-drivers transporting "illegal" refugees into the State to notice the report of possible homicide.
LONG-TERM patients in mental institutions, especially those with severe intellectual disabilities, will never emerge to tell their tales of terrible abuse and neglect. Perhaps it was partly with this in mind that in 1945 an Act was passed by the Oireachtas providing some measure of accountability for how such people were treated. It established the office of the Inspector of Mental Hospitals and the requirement that a report on conditions in mental hospitals be published annually.
For 19 years the Department of Health did not bother to publish this report. And, by the way, the 1945 Act also required the submission of the report to the president of the High Court, though none of their lordships noticed when the reports were not published.
Nowadays the reports are published annually all right but almost a year late and after a process of "consultation" which allows every vested interest an opportunity to attempt to sanitise the document. An example of this may be that while this searing indictment of the appalling negligence in relation to drug prescription, there is no follow-through elaboration of the basis for this indictment in the report.
But there is no point in having a report at all if nobody pays attention. No point if the failure of a private company to pay farmers for cattle is regarded as more of the material for a political crisis than criminal negligence in the treatment of vulnerable citizens in mental institutions.
FOLLOWING last week's column on this issue a professional in one of our mental institutions wrote to me. He asked that his identity be protected at this time. He wrote: "Just last week a young man who suffers intermittent traumatic delusions, but who nevertheless over the years has worked at patiently bearing his difficulties with dignity and putting into words during his sessions with me the nature of the world he inhabits, arrived at our appointment in a shocking state: his hands were shaking, he complained of frothing at the mouth, his speech was slurred and he had great difficulty concentrating enough to maintain his speech in the session.
"It was appalling to see a young man who has struggled so long to maintain some dignity in the midst of his difficulties and torments reduced at a stroke to a sad and pathetic figure. The explanation, it turned out, was that 10 days earlier he had seen a different psychiatrist (his usual practitioner being absent sick) who, following a consultation lasting a few minutes, had decided to embark on additional medication, including injections. This psychiatrist had never met the patient before.
"I could tell you so many similar and worse stories, and I could introduce you to nurses who could tell you even worse. One good-humoured nurse joked to me that if a patient was admitted to [name of institution] sane, he would have to become insane to survive more than two weeks there.
"There are many good, honest people amongst those working in the public health psychiatric departments, but none would dare speak out about such careless and arrogant abuse of patients' rights and dignity; their words would either be unheeded or their careers would suffer. If I spoke out my work could be terminated by the health board."
I don't think I would be abusing his confidence if I were to state that the health board he was referring to is the Eastern, the one that brought us the recent debasement of refugees.
Is it too much to expect that this issue might be raised in the Dail, amid the flurry of its other important concerns?