A cry for help no one answered
THE John Scannell that lies in a hospital bed bears but a fleeting resemblance to the husband, father and friend that people once knew.
Where once photographs showed a handsome face and a cheeky grin, there now lies a motionless body in a persistent vegetative state. An eerie silence hangs over him with the only sound in his hospital room, the echo of laughing nurses up the corridor.
John, 61, is fed through a tube pumped into his stomach and once a day, a tube is pushed into his throat and the fluid on his lungs forced out. He spends much of his day unconscious, as if in a constant sleep. If his family rub his feet or hands, repeating his name, he splutters into a higher level of consciousness, momentarily opening his eyes but seeming disturbed; perturbed. He often then lapses into brain seizures.
John Scannell suffered from depression, paranoia and deep anxiety. He had written an array of suicide notes in his time and spoken to all who would listen of his deep belief that he would never “get better”.
The notes that his daughter, Shirley hands to me are all written in the same erratic scrawl. All contain the name of Cork dockside landmarks where his body could be found. His families’ mobiles are scribbled at the bottom — the idea being that if the letter is found by a stranger, they can be contacted and told where the body is.
In April 2007, John started to display the symptoms of anxiety and fear that had characterised his periodic bouts of depression.
As the days went by he got increasingly paranoid and withdrawn. “It was if he started to build a shell around himself and he just retreated into it. He just sat there staring into space. He had never been so low. He was helpless and we were helpless,” said Shirley. Her mother, Margaret brought John to their local GP in Gurranabraher and the GP prescribed Valium and gave him a letter to present at the local acute psychiatric unit. He refused to go.
Shirley lived in Germany at the time and John was primary carer to her 34-year-old sister, Siobhan who has Down Syndrome. She started to get regular 9am phone calls from him, as he panicked outside the doctor’s surgery. “I don’t know whether to go inside or go drown myself,” he’d whisper.
By May, John was getting ever more unstable and irrational. He was now “so anxious that he was dripping sweat constantly. Also, he couldn’t drive anymore. He would just swerve all over the road and I was scared if we drove by a river that he’d drive us both in” said his wife, Margaret. His anxiety was feeding off his delusions and paranoia: he thought that everyone was “out to get him” so he started carrying a hammer around with him. His family were now terrified that their father, known to all as a soft, gentle man, would actually use it on someone.
Eventually in June, he presented at St Michael’s psychiatric wing at the Mercy University Hospital. “It was just like going to A&E. Despite the letter, despite our desperate need, we had to wait four or five hours to see a doctor,” said Margaret. Doctors eventually decided he was to be admitted but then, as his wife worked in the hospital, they decided, without consulting with her, that they might save her some “embarrassment” by sending him to Cork University Hospital, in the next catchment area.
John stayed at the GF psychiatric wing of CUH for two weeks, regularly repeating his wish to die to family. He was never seen by a psychologist or offered therapy for his anxiety.
“He was put on anti psychotic medication there but he was still unstable. I couldn’t believe that there was no effort to contain a man that was visibly unstable and suicidal,” said Margaret.
After a two-week stay, he rang Margaret to say that he had been discharged and was standing outside the hospital. His family were aghast. Why hadn’t they been contacted by staff? Why was he being discharged with no noticeable improvement in his symptoms?
“This John wasn’t the dad that I knew. John had a wonderful sense of humour. He was big into music and was well-known on the trad scene, he wrote poetry; he was brilliant with my sister Siobhan,” said Shirley. “This man was a terrified shell. He was having a breakdown and nobody was helping him.”
About three weeks after his discharge, he told Margaret that he was going to his friend Sean’s house for some music practice. He’d seemed calmer that day and taken more care than usual with his appearance. Margaret didn’t for a moment question him leaving the house, being glad to see him having a good day. He left the family home about 6.30pm.
At 10.30pm, Margaret got a phone call from that same friend, Sean to say that another friend had just rang him in a panic.
He’d just seen John staggering around the docks. John had never gone to visit Sean.
Instead he’d bought himself a bottle of vodka, sank several pints and took a handful of valium. His groomed dress that night was meant to hide the layers of clothing that he was secretly wearing underneath — to keep him warm in the water.
Ten to 15 minutes after he hit the River Lee, he was pulled out by emergency services. He had spent at least 10 minutes under water with his brain deprived of oxygen.
An ambulance rushed him to hospital and when his wife, Margaret arrived at the South Infirmary, she was told he was dead. John died twice more that night before he eventually pulled through, profoundly brain damaged.
Twenty months later, he has made no improvement. He never will.
According to the depression support group, Aware, John Scannell’s story is not an isolated case. Every week, they get dozens of calls from people desperate for help for their family members.
“More than 500 people in this country die by suicide each year. This is tragic enough, but when people die, or are left struggling to exist, having come forward and asked for help, that is absolutely unacceptable,” said Aware spokeswoman Sandra Hogan.
“It is an appalling reflection on this and previous governments that the mental health services in this country continues to fail those who are most vulnerable. Families throughout this country struggle every single day to get help for a loved one as a result of mental health issues, and yet lessons are not being learned.”
According to John Saunders of Mental Health Ireland, the acute psychiatric services in Ireland are characterised by “too little, too late”.
“There are clearly a number of failings in this case and in many ways it is very typical. This man was clearly high risk. That should have been recognised. Also, they could have involuntarily detained him as he was a risk to himself.
“Sadly, I’m not surprised that they discharged him after three weeks as there is such pressure on emergency beds,” he said.
“Families’ views have to be taken on board more by the psychiatric services.”
Six months after John Scannell’s failed suicide attempt, the family met with his clinical psychiatrist.
“He said he was sorry about what had happened and as far as he was concerned, John had stabilised before discharge.”
According to Margaret and her daughter, the psychiatrist also apologised for the unit not ringing them when discharging John, saying they were busy that day and new guidelines would ensure that this wouldn’t happen again.
“If this was the case of a man dying after a mistaken cancer diagnosis, there would be uproar. We can’t be the only people who have been treated like this. Why aren’t people talking about it? Sadly, I feel there is still a huge stigma attached to mental illness and families don’t talk out,” said Shirley. “I see all those TV ads telling people to be mental health aware. We were. They wouldn’t listen.”
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