Sir, – John FitzGerald draws welcome attention to the "forgotten lessons of the Spanish flu pandemic" (Business This Week, April 24th).
Even more forgotten is the fate of people with mental illness, a great many of whom were unjustly detained in vast asylums during the 1918-19 pandemic. A fifth of all patients in Belfast asylum died of the infection. One patient in every seven fell victim in the asylums in Kilkenny, Castlebar, Portlaoise and Armagh.
Today, the Mental Health Act, 2001 is a vast improvement on the laws that pertained at that time and our mental health services are, for the most part, based in the community.
Even so, people with mental illness are still at increased risk of neglect, homelessness, imprisonment and denial of rights.
Many have difficulties accessing healthcare at the best of times. Men with schizophrenia die 15 years earlier, and women 12 years earlier, than the rest of the population. The chief causes are heart disease and cancer.
The risks are even higher at times of emergency.
As a result, it is imperative that services for the mentally ill are not only protected but enhanced during Covid-19. Pandemics have an enormous effect on mental health.
One study of people infected during the outbreak of Sars from 2002 to 2004 in Hong Kong found that 59 per cent developed serious mental health problems. Earlier this year, a study of 1,210 people across 194 cities in China found that 54 per cent rated the psychological impact of the Covid-19 outbreak as moderate or severe.
There is no reason to think that Ireland will be any different and every reason to believe that people with pre-existing mental illness will be especially affected.
Equity is vital at a time of national crisis.
We must ensure that people with mental illness and their families are not neglected, as they were in previous emergencies. – Yours, etc,
BRENDAN KELLY,
Professor of Psychiatry,
Trinity College Dublin,
Dublin 2.