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I MET PAT when he was at his lowest ebb and had been on the streets for three days.
Pat had serious mental health problems. He was hearing voices and was also using drugs to try to kill the pain.
He had sat for hours in the Accident & Emergency department but unlike most other people there that day, he never received treatment.
The A&E staff did not assess him or admit him instead they referred him to an addiction service in Dublin city centre.
But when Pat attended that addiction service he told them that he intended to take his own life if the voices didn’t stop. So they sent him to psychiatric services.
The addiction service refused to work with him until his psychiatric illness was dealt with and the mental health services refused him because he was using substances.
Every door was closed on Pat. He was scared and exhausted, having left his house days earlier and was refusing to go back. He was convinced that there were people ‘after him’ and that when they caught him they would go after his family too.
He explained to me that he went to the hospital because he was frightened and his family had insisted it was time for him to get help.
Pat was having a definite psychiatric episode but shamefully because he was also a substance user, our psychiatric services refused to treat him.
A short time later I heard that Pat had overdosed in homeless accommodation and died.
Pat’s case might sound like an extreme one but anyone who works in homeless services will tell you that this issue is actually very common.
There are many, many sad and shameful cases of people being turned away from accessing health services because some of their issues are deemed to be non-medical.
When a person presents with psychiatric and addiction issues in Ireland they are routinely sent away and referred to addiction services – who in turn just send them straight back to the hospital.
What is going on is a fairly baffling attempt to separate addiction from mental health. It is as if the person taking the substance is separate from the person experiencing the mental illness, when in fact they are one person and the two issues are obviously interrelated.
Addiction is not a moral weakness but is itself a mental illness and it is listed as such in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association which is basically the psychiatrist’s bible.
When a person has both mental health and substance use issues, health professionals call this dual diagnosis. There are very few services here that work with people with dual diagnosis.
What always stands out to me is that the distinction between these two problem types is immensely arbitrary.
The underlying causal factors are the same – they are social issues, family breakdowns, poverty and especially trauma. It is fair to say that while there will be some difference in service provision they also have significant overlap.
Often the reason cited for discharge from mental health services is the addiction and vice versa – services blame the ‘other’ diagnosis for the person being discharged, without fully accepting that maybe they could and should have done more.
When someone takes their own life, people say:
Why didn’t they just ask for help? If only they had things could have been different.
Sadly, many people like Pat, do seek help and they are being turned away from mental health services.
Recently in a conversation with a clinical psychologist, he suggested that there is massive pressure on those who provide services. Not only are they under-resourced, but they are also trained to believe that their service cannot help or isn’t suitable for certain people.
A radical change of approach in supporting people with a dual diagnosis is now long overdue. We must resource and train all service providers to be able to respond to people in a holistic way.
My hope for 2019 is that our health service implements the ‘no wrong door ‘ recommendation of the Cross Party Committee on Mental Health.
That would mean that never again, would someone like Pat, be turned away from mental health services – or be told that they have knocked on the wrong door.
Lynn Ruane is an independent Senator.
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Sympathy to the poor woman, but serious sympathy to the poor truck driver, this is becoming all to frequent in this country, he was only doing his days work, minding his own business.
That poor woman. Her whole life turned upside down on a morning where we all should be just enjoying the sunshine and then this happens. Devastated for her.
This is utterly horrible. Poor young mum. Poor wee kid. Words fail me
So tragic. How is that mother ever going to get over this. Rip little man. Watch over your mam.
Looks like it was deliberate. I could be wrong but it looks like attempted murder of the woman and murder/ suicide of the child and man. I know that road well and if he was from Lattin he would know it well too and would know not to overtake. Rip to both and my utmost sympathy to the mother of the little boy.
He’s not eastern European, his parents are Italian, but he was born and raised here,
Don’t like the look where this story is going
It’s easy to condemn but the poor man must have been in a very distressed state of mind to do something like that.
RIP.
Fcuk him. He just destroyed a mothers life and murdered her son. If he lives we would all be saying he should be locked up. But now that he died we feel sorry for him. And don’t get me started on the funeral service for this fella where the priests says “it’s a dark day”.. This man just murdered his son and attempted to murder his partner. S(umbag
Ricky.. Most murdering b@stards are in a distressed state of mind
When a mother murders her children society reaches out the hand of compassion and understanding.
Why is it not the same for fathers?
Ricky. Murdering mothers are worse than mothering dads
Just think about what happened here for a moment………and reflect on how this situation spiralled out of control to this point. The human tragedy involved.
Can we truly say we understand it and as such are in a position to make a judgement call one way or the other?
Sinead I hope you are never in a situation where your mind is so badly messed up by depression that you are not thinking rationally. Obviously this man was out of his mind doing this and it breaks my heart that a little boy has died and his mother had to go through such an assault, but nobody knows his circumstances and shouldn’t be quick to judge that he was ” evil” . I’m not saying I agree with what he did because I don’t , but with serious mental health problems a while back myself I know that your mind does not think normally . I certainly hope this is the case with him because I’d hate to think this WAS an act of pure evil
Oh no. That poor little boy. Whether the crash was an accident or deliberate, no child deserves that.
So sad, too much detail re the crash. Horrible set of circumstances
It’s just so sad to be hearing about theses suicides , people should always realised that life is 2 step backwards and 1 step forward , this carry on could be avoided… RIP to the little lad … So sad !
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