Invisible pain needs compassion

Lady Gaga may be one of the main attractions of Irish cinema at the moment with her compelling remake of the 1937 classic movie A Star Is Born, but it is in one of her other roles as high-profile campaigner for mental welfare that she can be called to mind this morning.

Invisible pain needs compassion

Lady Gaga may be one of the main attractions of Irish cinema at the moment with her compelling remake of the 1937 classic movie A Star Is Born, but it is in one of her other roles as high-profile campaigner for mental welfare that she can be called to mind this morning.

Lady Gaga, real name Stefani Joanne Angelina Germanotta, speaking of people suffering from stress, anxiety and depression in 2016 famously declared “no one’s invisible pain should go unnoticed”. It was a sentiment which like Shakespeare’s Puck put a girdle round the earth in 40 minutes.

How disappointing it is, therefore, that yesterday’s final report of the joint committee on the future of mental health care illustrated, not for the first time, the regression in our treatment of, and attitude to, the mentally ill.

Prisons, say the authors, have become a “de facto” extension of the mental health system. Jails have long been one destination for people suffering from illness or forms of behavioural disorder but what is concerning is that their function is becoming cemented into place because of the lack of viable alternatives which offer hope and healing rather than static case management and discipline.

One damning statistic highlighted that inpatient beds reduced from 12,500 beds in 1984 to 1,000 beds in 2016 with 22 acute beds per 100,000 of the population. A major effort will be required to get that figure up to 50 per 100,000 in three years. The current European average is closer to 70. The comparatives become bleaker when the level of spending on counselling, and the availability of essential services, is measured alongside the provision and reliance upon psychotropic drugs used to suppress mind, behaviour and emotions.

Meanwhile the fact that patients are becoming younger and that targets for population growth are to increase the numbers of people living in Ireland by more than one million and the prognosis points directly to a crisis unless there is a dramatic change of priorities.

More people being failed by the system for longer. That won’t end well.

The decline of funding for enlightened provision has been achieved during a period which, despite the financial disaster of the Tiger years, has arguably seen the most dramatic period of real growth in the history of the Republic’s economy. The report’s 22 recommendations include the prospect of premium payments for psychiatric nurses, ongoing recognition in the caring profession that this specialism carries additionally challenging and strenuous demands.

The committee said it was “firmly of the opinion that acute services cannot continue to decline while we aim to reach the promised land of thorough and accessible primary care.” It added that “families may be trying to get members into prison in order for them to have better access to mental health services”.

If (this is) a causative factor to people becoming prisoners, whether intentionally or not, this should not be an acceptable state of affairs.

This is supreme understatement. The image of mad relatives being locked in the attic or drugged into a stupour is now regarded as Victorian or Edwardian melodrama. It has no place in a modern welfare state.

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