Alice Leahy, Delivering Opening Address at 25th Annual Nursing and Midwifery Conference at the Royal College of Surgeons

Urging nurses to become advocates for the most vulnerable, Alice Leahy, Director and Co-Founder of TRUST, said that the recent and welcome announcement that the Department of Health proposed to sell off the state’s mental hospitals’ was unfortunately not matched by an equally clear and unambiguous commitment to provide appropriate accommodation for the many patients affected who are now to be treated in the community.

Addressing the 25th Annual Nursing and Midwifery Conference at the Royal College of Surgeons Alice Leahy said we were on course to repeat the mistakes of the past: “Many of the people we meet who are homeless on the streets of Dublin have been patients in mental hospitals. They are living proof that the plan to close the mental hospitals and move services into the community over twenty years ago has not been a resounding success to date because inadequate services were provided in the community. Will we allow the same thing to happen again?”

Alice Leahy said that when the recent mental health strategy report was published it provided no compelling answer as to how the accommodation needs of patients were to be met, when the hospital were sold off, except to suggest that this ultimately was the responsibility of the local authorities. “However, at a time when over 40,000 are on the waiting list for housing such an approach represents a refusal to honestly demand that the most fundamental right of a very vulnerable group are properly protected because they would risk being left at the bottom of any list.”

Alice Leahy also pointed that after this obvious omission in the proposed strategy was strongly highlighted the Minister did respond with an idea, which was hastily leaked to a national newspaper, but still leaves many questions unanswered: “Only after some of us protested loudly did the Minister respond with the proposal that when the Mental Hospitals are sold for development, each developer will have to give an undertaking that a certain amount of housing will be provided on each site for those affected. This was revealed exclusively on the front page of The Irish Times on Saturday the 11th of February but sources suggested that it would be several months before the tender documents appear and we know the full details of what is proposed.

“Now we are all aware what happened regarding the proposal that a percentage of each new housing development had to be made available for social housing. Developers were allowed to buy their way out of that responsibility by making a contribution to the local authority. Will the same be allowed to happen in respect of people with mental and psychiatric problems?”

Alice Leahy said that nurses will have a unique opportunity to make a difference on this issue as they are going to be redeployed from the mental hospitals into community psychiatric care teams. However, if a strong stand is not made before the hospitals are sold it maybe too late to ensure that the right of patients to decent accommodation is safeguarded. Calling for the immediate appointment of independent advocates for patients in each hospital affected, Alice Leahy said that given the unfortunate history of how this transition process has been handled in the past we risk witnessing much needless suffering unless appropriate action is taken now.

“We need special safeguards to protect the human rights of these very vulnerable citizens. Independent advocates should be appointed to look after their interests during the transition to ensure that they do secure their right to appropriate accommodation and to prevent anyone becoming homeless. Indeed, the failure of the Minister when announcing the new mental health strategy to acknowledge the mistakes that have been made in the past make the concept of the advocate in this instance especially important,” ALICE LEAHY said.

Calling for nurses and doctors who will make up the proposed community care teams to become advocates in the areas where they will be based for their patients, Alice Leahy said this will also help to ensure they receive a more positive welcome by helping to allay the unnecessary fears that sometimes arise.

Pointing out that it is ironic that homelessness and mental illness both carry a stigma in Irish society and often impose a deep sense of isolation on the people affected, Alice Leahy appealed to nurses working in the community to be especially sensitive to the needs of those suffering from feelings of isolation and exclusion in all situations, even within families, because often that can ultimately lead to an individual becoming homeless.