Families embroiled in Owenacurra mental health mess deserve transparency and accountability

When those making decisions about their futures cannot give a clear account of their actions, patients will suffer 

The Owenacurra Centre in Midleton.

You may have read the word Owenacurra on more than one occasion in these pages in recent months.

Last June, it emerged that the HSE was planning to shut down the 24-hour staffed mental health centre in Midleton after 33 years in existence.

There were 19 residents in the facility at the time, some of whom had been there for decades. These are people with enduring mental health difficulties, amongst the most vulnerable people in Irish society.

The HSE said that it had concluded that the centre was unfit for purpose, both in terms of its structure and the fact its rooms no longer match what is considered best standards for such accommodation.

There it might have rested — a sad, possibly slightly cruel corporate decision leading to local angst but eventual acceptance — had the families of the Owenacurra residents simply rolled over. Instead they fought back, and hard. 

Marchers taking part in the public demonstration to protest against the proposed closure of the Owenacurra Mental Health facility in Midleton.

And now Owenacurra doesn’t feel like a small story anymore. In fact, it may be the perfect example of everything that is wrong with the bureaucracy of the Irish health service.

The easiest way to outline why this story matters is to trace how it has evolved since last winter. It also must be acknowledged here that most of the light shed on the Owenacurra story has come from the ceaseless efforts of local councillor for east Cork Liam Quaide and Green TD for Dublin Central Neasa Hourigan, who have simply not let the matter go.

At first, when the HSE announced the closure, there was a local outcry, and a series of gatherings in the locality to decide what could be done. Most of the local representatives in the area decried the decision and the fact it would leave a population catchment of more than 90,000 people in east Cork without a dedicated 24-hour mental health facility. 

Pottery teacher Susan Herlihy and Sheila Hennessy from Mogeely supporting the public demonstration to protest against the proposed closure of the Owenacurra Mental Health facility. Picture: David Keane

A closure date of October 31 was set, but quite quickly it became clear this could not be met, for the simple reason there was nowhere obvious for the residents to go.

Then the first signs that something was amiss began to emerge.

An FOI request to the HSE seeking information regarding the spatial dimensions of Owenacurra as compared with potential replacement wards at St Finbarr’s Hospital in Cork city and St Stephen’s Hospital in Glanmire, were met with by the HSE’s estates section bemoaning the “significant resource implications’ of such a request.

The materials regarding the room sizes of the various facilities were finally released once the Public Accounts Committee got involved.

Meanwhile, a request by Ms Hourigan for the correspondence between senior HSE managers in Cork/Kerry regarding the decision to close Owenacurra saw no records returned, a scarcely credible response.

A similar follow up query by Mr Quaide via FOI saw the HSE demand an admin fee of €600 in order to process the request. For any veterans of Irish FOI, such a response has a simple translation — "we don’t want to give this to you, go away".

But then the story began to branch into other areas of Cork.

With those affected desperately seeking answers as to where their loved ones where going to be living once Owenacurra finally closed, it emerged that the HSE had bought a former B&B in Carrigaline, some 30km away on the other side of Cork City, which had the potential to act as a replacement.

Leaving aside the imposition that moving such vulnerable people from their residence of many years would place on both them and their families, it soon emerged that there was more to the transaction than met the eye.

First it emerged that the building was purchased for €750,000 from the immediate family of a HSE manager, Kevin Morrison, the head of Cork/Kerry mental health services. Mr Morrison is the official charged with answering many of the questions of residents regarding the Owenacurra decision, and not always in the most obliging fashion, requiring some questions to be asked via FOI and thereby incurring both significant delays and a burden of work and cost for those asking. When the Irish Examiner  reported that fact, the HSE insisted that “all appropriate processes” had been followed.

It must be noted that FOI documents regarding the Glenwood sale affirm that Mr Morrison had recused himself from any decision-making regarding the sale due to that conflict. 

The Mental Health Commission has been informed that nine residents of Owenacurra will be offered places in Glenwood.

However, Glenwood has a) never been opened despite being purchased 16 months ago, and b) has already been offered as accommodation to residents of another mental health facility, Millfield House in Blackpool.

The Glenwood controversy kept rolling. It turns out the HSE had wished to expedite its purchase in order to empty out the privately-rented Garnish House, which has cost more than €1.1m over the past two years, in Cork Cty, and into which the Millfield residents had moved at the start of Covid-19.

Estates managers were informed two months prior to the sale in January 2021 they would have to apply for retention planning permission at Glenwood in order to change its purpose to a mental health facility. They didn’t bother, despite receiving an enforcement notice from the county council requiring them to do so. That planning application finally went in last month — 14 months late.

In the meantime, the HSE spent €500,000 on “minor works” overhauling Glenwood, installing wheelchair facilities and the like, and in the process reduced the number of bedrooms from 14 to 10.

So now there are 10 bedrooms to accommodate 9 people from Owenacurra and 15 people from Millfield/Garnish House. The sums do not add up.

Even further, despite listing the purchase of Glenwood as a means to do away with Millfield House, which it said was “unfit for purpose” in its own capital plan for 2021, the caretakers of Millfield recently heard that the HSE is “committed” to returning that facility’s residents back from whence they came as soon as possible. Which would see these vulnerable patients returned to shared room accommodation from the private rooms in which they currently reside at Garnish House. Remember, substandard room accommodation was one of the main reasons given for closing Owenacurra.

Eoin Underwood from Blarney and Laoise Kelleher from Cobh demonstrate against the proposed closure of the Owenacurra Mental Health facility.

And no renovations have been performed at Millfield in the meantime.

This is not to even mention the appalling communication from the HSE with everyone involved, including the local residents of Carrigaline who have objected en masse to Glenwood House being used as a mental health facility simply because they have never been told what is happening. When one local resident, a nurse, approached the HSE estates section directly they immediately demanded to know how she had found their email address.

This is a sorry saga. Thre are now 11 remaining residents at Owenacurra — exceptionally vulnerable people who are being removed from their home, a home they love, for reasons utterly contradicted by what has been going on elsewhere in the county. And no one seems to want to listen to reason.

At the Public Accounts Committee’s consideration of the HSE’s mental health budgeting in March, it was suggested that replacing Owenacurra on site would cost €8m, a figure Ms Hourigan, a qualified architect, dismissed out of hand as “extraordinary” and “out of whack with any construction cost”..

After months of writing about Owenacurra, it's easy to understand the Slaintecare ideal of devolved regional accountability. In Cork mental health services, there doesn’t seem to be any accountability whatsoever.

At this stage the residents of Owenacurra and Millfield House, and mental health patients across the region at large, would probably settle for just a little bit of fair play and some transparency from the people making decisions about their futures.