System fails John as cry for freedom falls on deaf ears

JOHN Hunt turned 30 on Saturday and spent the day as a free man.

He is no criminal, but after passing the day with family and friends, he was forced to return to his place of residence for the last four and a half years — a psychiatric intensive care unit in Cork city where he is being detained under the Mental Health Act as an involuntary patient.

On the day we meet in the small and uninviting visitors room at the hospital where he lives, just a few days before his birthday, he is looking forward to getting out, and smiles widely at the thought.

Clearly heavily-medicated, although he is a little confused at times, John is placid and amiable.

And when it comes to one topic in particular, perfectly lucid — he wants to get out.

His partner Gráinne and four-year-old son Joshua want him home too, but his doctors believe he is better off in Carraig Mór, a two-storey unit in the grounds of the former Our Lady’s Hospital, and Gráinne has been told John is seen as “suitable” for long-term hospitalisation.

John was first admitted to the unit after suffering a breakdown and has been diagnosed at various times as being bi-polar or schizophrenic.

He has been on a cocktail of drugs for years, and they have caused a serious deterioration in his physical condition.

He does not see the outside of the unit from one day to the next, the gated garden out the back is small and overgrown.

There is no psychologist to work with him, and he is well on the way to becoming institutionalised, although he is quite clear about wanting to get home.

John’s case is not typical, but is not unusual either, and highlights the inadequacies in the mental health system whereby people are being held indefinitely in psychiatric units, on high doses of medication, without seeming to make any progress.

According to the most recent Mental Health Commission inspection report of Carraig Mór, “the lack of a rehabilitation team is regrettable, particularly in view of the fact that a number of residents had been resident for longer than six months.” It also notes no psychologist has been recruited as recommended.

According to Consultant Psychiatrist Dr Siobhan Barry, under the Mental Health Act 2001, a person should only be detained if they are likely to benefit from treatment, and it is incumbent on a doctor to show that this is the case when seeking further detention.

“If someone has plateaued and you cannot show that they will improve through further treatment, then you have no reason to continue holding them,” she says.

Indeed, the 2001 act set up mental health tribunals to automatically review all decisions to protect patients’ interests. Under the act, the Mental Health Commission appoints a solicitor for the patient and a hearing determines if the person should be released or not.

According to Mark Felton, chairman of Mental Health Lawyers Association, and an experienced tribunal solicitor, people end up being detained for many years.

“As long as the doctor says that is what’s needed, then that is what will generally happen.”

“We have no low-security forensic unit in this country for people who are held for long periods. Doctors do their best with what they have available to them, but it is not always what is in the best interests of the patient.”

It is clear to all that John Hunt is not ready to leave Carraig Mór for good this week, or even next month, and his family accept this.

But it is not acceptable to them that there is no alternative to long-term hospitalisation for John.

Gráinne firmly believes he needs therapeutic interventions, such as psychotherapy, to deal with his underlying issues.

She does not necessarily blame John’s doctors, more the system that allows a young man to vegetate behind locked doors.

She believes John is on a worrying amount of medication and has expressed her serious concern about long-term brain and kidney damage to his doctors.

“I would like some plan to be put in place for gradually re-introducing John to life outside Carraig Mór,” Grainne says. “John has committed no crime and yet he is locked up.”

Grainne does not accept Carraig Mór is the only future for the father of her child and has vowed to continue fighting until some solution can be reached to give him the chance for a better life.

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