Madam, - There is currently a stand-off between the Irish Prison Service and the Central Mental Hospital on the treatment of "mentally ill" prisoners. We at the Irish Penal Reform Trust (IPRT) are compelled to speak about this issue, given its potential ramifications for the human rights of people in prison.
The Central Mental Hospital has always been the main facility in the State for treating all mentally ill and mentally distressed prisoners. There is a long tradition of care and treatment by the hospital and its medical staff.
Despite this, the Central Mental Hospital is now, in practice accepting only prisoners who have been certified as "insane" under an involuntary admissions procedure. In the words of the hospital's director Dr Harry Kennedy, "only the most severely ill patients are transferred and in practice these are almost always involuntary admissions of patients incapable of giving consent".
The IPRT has been attempting to raise awareness of the treatment of mentally ill/distressed prisoners (a group comprising up to 40 per cent of the prison population) for some time. If the Central Mental Hospital is suddenly refusing to accept all but the most severely ill prisoners, then the pressure shifts on to the individual prisons to ensure that the mentally ill are treated in accordance with international human rights standards. However, the prisons are not equipped to take on this task. Indeed the Director of the Prison Service, Sean Aylward, is himself on record as saying that the treatment of the mentally ill is not the sort of function that the prisons can or should undertake.
The IPRT has vigorously pursued the issue of padded/observation cells in prisons as an example of the poor treatment of mentally ill and distressed people in the prison system. A recent paper by Dr Valerie Bresnihan on behalf of the IPRT debunked claims by the Minister for Justice that there have been improvements made where these cells are concerned. The report found that few meaningful improvements have taken place since the IPRT first highlighted the issue several years ago.
As a direct result of the new policy of the Central Mental Hospital, prison doctors are now under pressure to certify prisoners as "insane" in order to relieve pressure on the prisons and to secure the treatment the prisoners need in the Central Mental Hospital.
The dangers of misdiagnosis are considerable in these circumstances. To certify a person as insane is a most serious step with considerable consequences for that person's future.
This shambolic situation is not helped by the current stand-off. The Director of the CMH, Dr Harry Kennedy, refuses to accept that there is any change of policy in relation to admissions (Sunday Tribune, September 21st) or any particular problem in relation to observation cells, and accused the IPRT and Dr Bresnihan in particular of "wilful inaccuracy".
There is an urgent need to address the issue of how the mentally ill are treated in our prison system. It is time to move away from the culture of secrecy, denial and bureaucratic obfuscation and face up to our clear and unambiguous obligations under international human rights standards. - Yours, etc.,
EDWARD BOYNE,
Chairperson,
Irish Penal Reform Trust,
Bloomfield Avenue,
Dublin 4.