Investigation appeal amid disturbing concerns over Mayo mental health unit

Mother of autistic adult patient cites impact of ‘unsuitable service’

An appeal has been made for Health Minister Stephen Donnelly to seek an independent investigation into disturbing concerns being raised about the adult mental health unit at Mayo University Hospital in Castlebar.

A worried Mayo mother, who wishes to remain anonymous, has highlighted concerns that the facility is used as ‘a holding centre’ for autistic adults who are denied the proper support and services they require.

The parent contacted The Connaught Telegraph after the newspaper highlighted issues raised by the Mental Health Commission in the aftermath of an inspection.

The commission was particularly concerned over low staffing levels at the facility, most notably in regard to psychiatric nurses. It revealed the number of registered nurses had dropped by 14 to 30 since 2011, creating a serious void at the high dependency unit which caters for 32 residents and involuntary residents.

In a sad and disturbing statement, the mother of the autistic adult was not critical of the staff but the model of treatment, which she described as dating back to the Victorian medical model.

She explained: “I was not at all surprised by the recent revelations emanating by the Mental Health Commission concerning the adult mental health unit at Mayo University Hospital.

“But the issues were something I was unaware of prior to making the unenviable and regrettable decision to admit my son to the facility.

“My son is not ill, he is autistic. After his admission to the unit, and to my horror, I soon came to realise it was being used as a holding centre for autistic adults who have historically been denied services or support.

“Autistic adults across the country experience the knock-on effect of being denied support and services as children and find themselves frustrated, anxious and often distressed once they reach adulthood. This was the case for my son.

“My son has spent months on the adult ward. He isn’t being ‘treated’ because he isn’t ill. He should have been discharged months ago but his team detain him for the vague chance a ‘service’ will magically appear.

“There he remains waiting, desperate to come home, traumatised and frightened that he will never be allowed to leave hospital and never live with his loving family again. My son is autistic. He is not an offender. Even prisoners receive a discharge date - my son has not. It is cruel.

“The adult mental health unit at MUH is not fit for purpose for autistic adults or many others for that matter. Recent revelations from the Mental Health Commission point to that.

“Apart from the unsuitable environment, staff, by their own admission, are not trained to work effectively with autistic people and do not understand neuro-diversity much less the autistic condition.

“Even if they did understand, their reduced numbers prevent them the time to engage in autism informed training or strategies.

“While nursing staff do the best they can with the tools they have, they are stretched beyond breaking point and are unable to assist patients beyond the most basic feeding, watering and medicating.

“The public may have the perception that a mental health unit is staffed day and night with psychologists providing one-to-one assistance and support as and when needed. This is not the case. When residents become frustrated at their prolonged, and in my son’s case, unnecessary stay at the hospital, it is overworked nursing staff who are responsible for putting a human face to an inhumane environment.

“Often, chemical and physical restraint is used for those unable to cope. For autistic adults who have found themselves at the wrong end of these practices, they can and do develop trauma and PTSD. For autistic adults who aren’t even ill, it’s doubly traumatic.

“For my son, the mental health unit is no more than institutionalisation by stealth. He continues to live in what can only be described as a prison.

“He and others spend 99% of their days in bedrooms or communal TV rooms. Patients are surrounded by the incessant noise of staff, other patients and the constant opening/closing of locked doors. There is no privacy.

“Activities like cooking, music and art are posted on the walls of the unit. My son has never had access to these activities due to the shortage of accompanying staff.

“The only thing he looks forward to is visits from family and friends and even these have been recently cancelled due to a shortage of visiting rooms on the ward. No one in Mayo has counted the damage perpetrated on those forced to endure such conditions.

“When my son is discharged it will be him alone who will have to cope with his experience. If any parent of an adult autistic child believes that what has happened to my son couldn’t happen to their loved one, they are mistaken.

“If they look elsewhere in Ireland or the UK they will find that autistic adults have been detained, sometimes for years on similar wards due to lack of outside support, with many of them forced into residential facilities far from their loving families and communities.

“The use of adult mental health units as holding centres in lieu of services should never have happened. The Victorian medical model of treatment is alive and well in the mental health service. This is 2023, not 1903.

“While much lip service is paid to ‘listening’ and ‘recovery’ within mental health, this is not my son’s experience. He isn’t ill, he is autistic, and he has nothing to recover from except his traumatic and ongoing detention. County Mayo can and must do better.”

Former Castlebar councillor Harry Barrett said this mother is now putting a human face on what happens when your local adult mental health unit is not up to standard.

He stated: “In its present state, as outlined by the Mental Health Commission, this facility is lacking sufficient nursing staff, the skills mix to deal with complex cases, the ability to maintain the building safely and the inability to manage their general health of patients.

“So what do we expect when a poor mother has to fight tooth and nail to get a service to deal with her son’s autistic needs.

“Her letter describes all of the above and the impact it is having on her autistic son. However the impact is cruel and degrading and must be acted upon immediately.

“This brave lady is describing reality and what the next family in this county will encounter when they ask for a service in our adult mental health unit. The next family, from anywhere throughout the county, will also suffer the consequences of allowing our adult mental health unit to become run down.

“Staff are working as hard as they can but, as ever, they’re just aren’t enough of them and they do not in many cases have the skills needed to deal with the complexities. Now management need to issue a statement immediately about the facility in general and this case in particular.

“I want to see this case raised on the floor of Dáil Éireann and indeed I would demand an investigation by the Minister for Health. I will work towards this.

“This government has left us with an adult mental health unit stuck in the 1980s and we must work to change all of this.”

The HSE does not comment on cases of this nature.