September 11, 2009
A SOCIAL work service available for emergencies on a 24-hour, seven-day a week basis has been called for in a new report commissioned by the Mental Health Commission and An Garda Síochána.
The report also highlighted criticism by gardaí of the role of some GPs in crisis situations. Gardaí interviewed told of the frustration experienced when GPs refused to certify a person after gardaí had been called in a crisis situation.
“Garda experience was that GPs can be extremely unwilling to certify the person, particularly when they know the family,” the report noted.
Gardaí also expressed frustration with the hospital admission protocols, particularly where a person in crisis was brought to hospital and had to be escorted home again because a doctor refused to admit the patient.
The Report of the Joint Working Group on Mental Health Services and the Police was commissioned three years ago to recommend how gardaí and the mental health services could best work together.
Dr John Owens, working group chairman, said the need for an out-of-hours social work service had been advocated for some years “and its lack has been highlighted in a recent tragic incident”.
A report released in May into the deaths of a family of four in Monageer, Co Wexford in 2007 called for the provision of a national out-of-hours social work service to ensure an appropriate response to serious child protection and welfare concerns.
Calls for an out-of-hours social work service were also made following several other family tragedies in recent years. Two of the seven recommendations made by the working group highlight the urgency of implementing national policy in the Vision for Change document and the “Primary Care Strategy”.
The recommendations involve speeding up the move to community-based mental health services and better liaison between primary care teams and community mental health services.
Dr Owens noted that these documents had been accepted Government policy for years “and the failure to implement them in full is a matter of great concern”.
The report called for a feasibility study on the appointment of crisis intervention teams staffed by gardaí and mental health personnel. It says the Health Service Executive should consider setting up a pilot 24-hour crisis team in a designated urban area. It also called for more training for gardaí to deal with cases involving mental illness.
The report found that people using mental health services had ambivalent feelings about the arrival of a uniformed garda during a crisis situation. Some said it could evoke fear of having done something wrong, while others said it created a climate of trust.
Dr Owens said publication of the report came “at a most appropriate time given the recent series of tragic incidents nationally involving individuals in acute social stress”.
Many social crises in the community were of a psychiatric nature yet An Garda Síochána was the only agency immediately available day or night to respond to these crises, Dr Owens said.
He said gardaí were “often unfairly and inappropriately left to deal with mental illness and associated social crises with very limited support”.
An Garda Síochána and the Mental Health Commission jointly welcomed the publication of the report, and said it would influence and inform future working relationships between gardaí and the mental health services.
Garda Commissioner Fachtna Murphy said he was fully committed to ensuring that the recommendations relating to An Garda Síochána would be fully implemented.
Mental Health Commission chairman Dr Edmond O’Dea said the recommendations would not involve significant financial outlay “but rather the will to address the issues raised, and the commission will closely monitor the progress being made”.
WHAT GARDAÍ SAY
Garda stations are a magnet for depressed people. They come to the station and it's three, four, five o'clock in the morning when they're mentally at their lowest ebb . . .
"You're there with this person who you know in your heart and soul is not right at this time. The problem is the doctor won't certify him, and then you're helpless because you just let them go back on to the street and you know within half an hour the phones are going to be hopping again that this fellow is walking out in front of cars or doing this or that . . ."
The problem ends up with you taking a knife and cutting a fellow down off a tree . . . or taking a body out of a river . . . we shouldn't be getting to that stage at all . . ."
"You are not a trained person and you don't know what, something you say could just set them off . . . with the best intentions in the world . . . we're not qualified counsellors, so we could end up doing more damage than good at times . . ."
Source: Report of Joint Working Group on Mental Health Services and the Police 2009"
This article appears in the print edition of the Irish Times