PRISONS ARE toxic places for people with mental illness. But because of the inadequacy of our mental health services, many vulnerable, inadequate and mentally unwell people are sent there. Now, the Government plans to tacitly acknowledge this unacceptable practice by building a new Central Mental Hospital on the Thornton Hall prison site in north Co Dublin.
Such a co-location arrangement was not considered socially or medically acceptable 150 years ago when the Central Mental Hospital was first built in Dundrum in Dublin. At that time, it was felt necessary to draw a sharp distinction between custodial and therapeutic settings, between criminality and mental illness. What has happened to change that enlightened attitude? Was it merely administrative convenience? Or was co-location seen as a clever way of funding both the new prison and the hospital through the sale of an extremely valuable site at Dundrum? Whatever the cause, the decision should be reversed.
Cogent reasons why a prison site in a rural area is unsuitable for a new Central Mental Hospital were provided by medical and civil rights organisations in Dublin yesterday. Australian professor of forensic psychiatry Paul Mullen said international experience showed that a custodial, rather than a therapeutic philosophy would take over on a co-location site. The new hospital would not be easily accessible to visitors and would pose problems for the rehabilitation and treatment of inmates in the community. The scheme, he said, did not reflect best international practice. Rather than relocate the Central Mental Hospital to Thornton Hall, economist Jim Power suggested that sale of a portion of the existing site would raise more than enough money to build a modern facility at Dundrum. This approach would accord with the view of medical experts, he said, and would provide the best outcome for patients, their families and medical staff.
The slogan of those campaigning against the transfer of the hospital from Dundrum to Thornton Hall is "Patients, not Prisoners". It gets to the heart of the matter. It draws attention to the disgraceful way that people with mental illness are frequently neglected and abused by authority. Prisons have been used as handy dumping grounds for mentally ill people. And individuals are frequently sent to jail for minor offences arising directly from their psychosis. The incidence of severe mental illness in our prisons is double the EU average and 40 times higher than in the general community. Blurring the line between custodial and therapeutic care by establishing prison and hospital facilities on the same site would make institutional reforms more intractable.
Mental health services are notoriously under-funded. Dundrum hospital should be demolished and replaced on the present site by a modern larger facility. Work was to have started three years ago. But those plans were shelved in favour of the Thornton Hall project. Locating a new hospital beside a prison complex is unacceptable for many reasons and would perpetuate old prejudices. It is appaling, indeed offensive, to today's values.