Madam, - We read with great interest the incisive and insightful column by Breda O'Brien (Nov 11th) concerning the interview given by Minister of State Tim O'Malley recently to the Irish Medical News (Nov 6th). We too were astonished and dismayed by this interview, in which he stated, "There's a very strong view with a lot of people that depression and mental illness is not a medical condition, that it's part of life's events that people get depressed or get unhappy". He then expanded on the theme by suggesting that the problems incorrectly defined as mental illness are the result of having nobody to talk to, adding that ". . .in former times people had much more time to liaise with each other and discuss things. . . if there were difficulties people discussed those difficulties and sorted them out".
This interview highlights for all how ill judged, ill informed and imprudent are the comments of our Minister with responsibility for mental health. His comments have restigmatised many thousands of people with mental illness and by suggesting that they simply lack somebody to chat to he has undermined the suffering of this particularly vulnerable and frequently silent group in Irish society as well as trivialising the suffering of their families.
His belief that the benefits of the medications used to treat mental illness cannot be proven scientifically in the way that other medications can is not only completely erroneous but irresponsible and positively dangerous. His casual undermining of the effects of medication in mental illness may well encourage those who are being treated with such medications to abandon their treatments, to the detriment of their personal health and safety and even of their lives. In implying that mental illness cannot be the subject of scientific methodology, he disparages the output of thousands of researchers working in psychiatric epidemiology, psychobiology, genetics, neuro-imaging, pharmacology etc, whose results are accepted by the wider scientific community and published in the most prestigious peer-reviewed journals.
Mr O'Malley correctly states that 95 per cent of people with mental health problems can be managed in the community. That is in fact what happens, as most patients are treated by general practitioners or in psychiatric out-patient clinics. Only a minority who are psychotic, disturbed or presenting an immediate suicide risk are admitted to hospital.
Even so, practising psychiatrists regularly have to discharge patients before they are fully recovered in order to create a bed for somebody more desperately ill, or find themselves forced to keep patients in an accident and emergency department for several days until a psychiatric bed becomes available. Such psychiatrists, nationwide, will be more than alarmed at the Minister's stated views about mental illness and his questioning of the need for more acute beds and may reasonably suspect that it is the financial cost of in-patient treatment rather than a genuine ignorance of mental health that is informing his alarming and ideologically toxic comments. Rather than this casual dismissal of our concerns about bed shortages, especially in urban areas, we would urge the Minister to meet us and other concerned parties to discuss the real crises in mental health provision in Ireland and the resources required to alleviate them.
The Irish psychiatric services that are the responsibility of Mr O'Malley are in a perilous state of neglect, lacking full multidisciplinary teams including psychologists, psychiatric social workers, occupational therapists and clinical nurse specialists throughout the country.
Perhaps we can now understand the reason for this. The man in charge does not believe that mental illness exists and reckons that all that is needed is a buddy.
We strongly urge the Minister to properly inform himself about the speciality he is supposed to be serving, in particular the needs of those with severe, enduring and relapsing mental illness, instead of singing off the hymn sheets of vested interest groups who deny the existence of mental illness. Alternatively, on behalf of the thousands of men, women and children of Ireland with such mental illnesses whom he has insulted and restigmatised by his comments, Mr O'Malley might wish to consider his Ministerial position. - Yours, etc,
PATRICIA CASEY MD, FRCPsych, FRCPI, Professor of Psychiatry, University College Dublin and Matermisericordiae University Hospital;
TIMOTHY DINAN, MD, PhD, FRCPsych, FRCPI, Professor of Psychiatry, University College Cork;
MICHAEL GILL, MMRCPsych, FTCD, Professor of Psychiatry, Trinity College Dublin;
COLM McDONALD, MB, PhD, MRCPsych, Professor of Psychiatry, National University of Ireland, Galway;
KEVIN MALONE, Md. FRCPI, MRCPsych, Professor of Psychiatry, School of Medicine and Medical Science, SVUH/University College Dublin;
KIERAN MURPHY, M Med Sci, PhD, FRCPI, FRCPsych, Professor of Psychiatry, Royal College of Surgeons in Ireland and Beaumont Hospital.