Madam, - The findings of the expert report on the suicide of 21-year-old Anne O'Rahilly make truly grim reading (The Irish Times, October 16th).
The president of the Irish Association of Suicidology, Mr Dan Neville, is right to praise the O'Rahilly family for pressing for this inquiry into the medical treatment received by their daughter. Too often, he says, the stigma attached to suicide prevents families challenging why their loved ones have died.
The lessons of the tragedy will, according to the Department of Health, be incorporated into future national guidelines. But where will this get us? There is now a lot of good work being done to identify and engage potentially suicidal teenagers and to reduce the known risk factors for suicide, such as bullying, isolation and low self-esteem. However, there remains one gaping hole in the services - the lack of inpatient psychiatric beds for seriously ill adolescents - and no amount of spin by the Department of Health is going to fill it.
The reality is this: if your teenage son or daughter is acutely psychotic, hallucinating, tormented by paranoid delusions or profoundly depressed and hearing voices telling him or her to commit suicide, you will have little or no chance of getting him or her into a psychiatric hospital when this is needed - which is immediately.
Outside Dublin and Galway there are no adolescent psychiatric inpatient units. Those that do exist are usually full and, in my experience, cannot respond to an emergency outside their own area.
This problem has been pointed out repeatedly to the Department of Health by psychiatrists over the past 10 years at least - but there are now even fewer beds available to adolescents than there were a decade ago (since the closure of the adolescent unit in St John of God's Hospital).
We have all seen the proliferation of Government guidelines, glossy brochures and strategy documents with categories and sub-categories on the most laudable policies and procedures you could ever imagine - but to what end? What has been achieved for 15-year-olds with no hope, no wish to live and a determination to end the misery that is their current life? And most of the paperwork ends up in the bin, to be replaced by the next, even glossier, even more expensive, revised edition - one that allows the appearance of change to continue while the gap in services gets ever wider.
Don't show us more guidelines, Ms Harney. Instead, show us the beds. - Yours, etc.,
Dr DECLAN SHEERIN,
MD MRCPsych.,
Child Psychiatrist,
Stocking Lane,
Dublin 16.