Helping to change the face of our mental health services
Sticks and stones may break my bones but names will never hurt me, goes the rhyme from my childhood, chanted with bravado, to rebuff a taunt, to keep a bully at bay, and to put a brave face to being shamed.
As children, we were told that words could only hurt if you let them.
But the reality is different.
My reflections are provoked by a comment found in Catherine Shanahan’s article Unit Bosses Fail to Park Mind Over Matter, in the Irish Examiner on February 16, about negotiations between the HSE and staff representatives on the planned opening of the new acute psychiatric unit at Cork University Hospital.
In a comment about the new unit’s standalone status on the hospital campus, Ted Dinan, professor of psychiatry at University College Cork, said: “We are going to be the loony bin at the side of the main hospital... it’s going to be obvious to everyone that if you walk in there, you have mental health issues.
“Why should psychiatric patients not be entitled to walk in the main door the same as everyone else? It’s the only unit in the entire hospital that is not integrated.”
Prof Dinan may have good intentions, to protect people from stigma, but his words have reinforced that very stigma about mental health and can only put a negative light on mental health care in Ireland.
The phrase ‘loony bin’ is a phrase that hurts. It is a phrase that stigmatises and feeds the fear and misunderstanding that is at the heart of discrimination.
It devalues the commitment of the Government, the professionals, and communities who are modernising our mental health services.
Many people I have spoken to are angry, hurt, and offended by Prof Dinan’s use of this term. They are people with mental health difficulties who are leaders for change. They are family members involved in advocacy. They are educators and staff.
Many are people who were involved in the design of the new unit. These are people who know that openness is the best way to challenge stigma. That there should be no stigma in service users walking through the front door of a mental health facility.
Indeed, this kind of openness, which is growing in Ireland, is being fostered by more than 90 voluntary organisations, State agencies, universities, and youth groups that make up the See Change partnership. Such openness gives confidence to others to seek help.
We must watch our words because mental health is today the concern of everybody. As a nation we have finally learned the importance of taking care of our physical health. Increasingly, people see mental health in the same way.
Now, we are learning to mind our mental health and to learn about what keeps us well — to understand our thoughts and feelings, our reactions, moods, and ways of behaving.
We now know that connecting with others, being active, taking notice, learning and giving are the actions that are most important for mental health and well-being. For people with mental health difficulties, friends and community play an enormous role in supporting their recovery. Recovery is an important concept in mental health today. It represents the very personal journey of people recovering from mental ill-health. It also represents the cultural changes that are happening in Ireland in the transformation of our mental health services into modern person-focused services. The challenge now for professionals is to leave behind the attitudes, beliefs, and behaviours of the institution and to develop services in partnership with the communities they support.
The prase ‘loony bin’ is a hangover from the 19th century. Across Ireland, there are still the old asylums and psychiatric institutions that remind us of those dark times when mental health was seen as something shameful.
By the 1950s, Ireland had a higher proportion of people incarcerated in psychiatric institutions than any other country, often for the most egregious reasons and in far greater numbers than the industrial schools or the Magdalene laundries.
These people were kept apart from their communities. There has been no tribunal. There has been no inquiry to address the damage caused to so many. This is the history we are trying to understand and move beyond.
Today, Cork is at the centre of mental health advocacy. UCC is a centre for new ideas and critical thinking.
This week I will attend the graduation of 17 students — the first group to complete the new Certificate for Mental Health in the Community, a partnership between UCC, Adult Continuing Education and Mental Health Ireland. The programme was designed and delivered by people with experience of mental health difficulties, mental health professionals, and advocates. These are people with passion, confidence, and dignity, fostering a new kind of mental health activism within our communities. They are helping to change the face of mental health services in Ireland.
Orla Barry is chief executive of Mental Health Ireland
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