Madam, - Finbarr Fitzpatrick of the Irish Hospital Consultants' Association states in his letter (Nov 2nd) that the association's "sole aim during these negotiations [with the HSE on the establishment of mental health tribunals in accordance with the 2001 Act] has been to ensure that the Act when introduced will work to the advantage of the involuntarily detained patients".
Unfortunately (though not at all surprisingly) the IHCA has failed to ask such patients what they consider to be to their own best advantage.
I should like to refer Mr Fitzpatrick and his colleagues to statements made by those who speak on behalf of those who experience mental health problems.
The Irish Advocacy Network, Schizophrenia Ireland, Grow, the Irish Patients' Association and others all agree that blame for the delay in the implementation of the Mental Health Act 2001 lies fairly and squarely at the door of the IHCA.
Those who are genuinely acting in the interests of the patient demand that consultants quit procrastinating and prevaricating and instead meet their legal and moral obligations. - Yours, etc,
KEVIN McPARTLAN, Secretary, Irish Advocacy Network, Old Roosky House, Monaghan.
Madam, - Finbarr Fitzpatrick, secretary general of the Irish Hospital Consultants' Association (Nov 2nd), writing in relation to criticism of consultant psychiatrists for the ongoing delay in establishing mental health review tribunals, makes the point that the mental health service has been neglected and underfunded for decades by successive governments. This is certainly true, and is an ongoing and well documented scandal. The professionals working in the service have been, and continue to be, victims of this neglect. Trying to provide the best possible service in adverse circumstances can be a difficult and thankless task.
However, the overwhelming priority in the current situation must be the service users and their families. There is no valid reason why resource constraints would in any way justify the IHCA in refusing to authorise its consultant psychiatrist members to participate in the tribunals.
Consultants' accountability for their decision-making in admitting, detaining and treating involuntary patients - as provided under the Mental Health Act 2001 - should operate in any mental health service, however poorly resourced.
While it is impossible for anyone to defend the record of successive Irish governments when it comes to treating mental health equitably, the establishment of the tribunals cannot be made conditional on the full resourcing of mental health services. Both are essential, but they are separate concerns for separate forums.
This ongoing impasse is causing unnecessary suffering and distress. It is a huge thing to know that your liberty, or that of a loved one, is being removed without the necessary protections in law to safeguard your, or your loved one's, human rights. The rights of this most vulnerable group of people must be the paramount concern for all parties in this process. - Yours, etc,
SEÁN LOVE, Executive Director, Amnesty International Irish Section, Fleet Street, Dublin 2.
Madam, - I have been following the ongoing disagreement between the Mental Health Commission and the HSE and the IHCA. It appears that the letters' authors (Martin Rogan - Oct 25th, Finbarr Fitzpatrick - Oct 22nd, Nov 2nd) are under the assumption that the mental health and the rights of Irish citizens with mental health difficulties are the priority of the HSE at the negotiating table.
It is becoming increasingly clear, however, that the HSE's preference is for statements of positive intent followed by an apparent deficit of practical action to support same.
The experience of clinical psychology training in this State illustrates this perfectly.
Clinical psychologists work in the assessment and treatment of mental health difficulties in adult, child, learning disability, forensic and brain injury settings. Following a seven-year review an Impact/Employers (ie HSE) Joint Review Group produced an agreed report in 2002 stating that 50 psychologists needed to be trained annually to meet the increasing requirements for psychological services across the State.
The Department of Health and Children agreed to meet this target and NUI Galway agreed to set up a training course.
Although the payment structure for clinical psychology trainees exists as per Department of Health and Children consolidated salary scales, funding for trainees has been an ongoing source of dispute. Following a Labour Court recommendation 10 months ago, the HSE (North West) continues not to pay salaries to its clinical psychology trainees, thereby jeopardising training. I wish I could echo Mr Fitzpatrick's statement that he has been negotiating with the HSE, but so far they have refused to meet any of the trainees. - Yours, etc,
JUDITH McBRINN, Clinical Psychology Trainee, Cappagh Road, Galway.