Furore over transfer of addiction service to UHG psychiatric unit
By Mary O’connor
The man who set up the then Western Health Board’s addiction counselling service 27 years ago says he fears its planned transfer to the psychiatric unit at University Hospital Galway will signal the death knell of this vital service.
Retired addiction counsellor Jack Mahony told this newspaper that it was originally located at the psychiatric unit when it was first set up in 1986.
However he says both he and its then clinical director, professor of psychiatry Tom Fahy, recognised the service was located in the wrong place.
“It was poorly attended, people didn’t want to be coming there,” says Mr Mahony. “Professor Fahy then decided to move it to Merlin Park, he wanted it out of the psychiatric unit, he saw it wouldn’t be a success. He was a man who was way ahead of his time. We recognised that alcoholism was not a psychiatric condition. I looked for a new premises and we moved to Merlin Park in 1987. The service only began to be used when we moved there. Joe Treacy [one of the current addiction counsellors] joined me a month later.”
He describes the controversial decision now to shift the service back to the psychiatric unit as “outdated” and says he has grave concerns about its repercussions.
“It’s probably the death knell of it,” he warns. “Service users won’t go into the psychiatric unit, alcoholism and addiction are not psychiatric conditions. The HSE is only paying lip service, it’s not really developing the service. One of the reasons I left was because of the lack of input from the HSE in furthering the service. It was just cut, cut, cut, it didn’t allow me to do my job properly. The service was just chipped away at, it was never resourced. There was a better [resourced] service in 1987 than in 2013.
“We were the first service in Ireland that ran an educational treatment programme on alcoholism on a daily basis. It was evaluated by a clinical psychologist from Arizona called Dr Don Casey. He couldn’t get over the fact that any two people (Joe and myself) could do so much with so little resources.
“Since the health boards were dissolved a lot of services disintegrated. We had great support from hospital management then, such as the late WHB CEO Eamon Hannan, Pascal McDaid and Bernie Haddigan.”
Meanwhile worried clients of the addiction counselling service are appealing to the public to support their campaign calling on the HSE to change its mind about the planned transfer.
The service, which caters for 50 people daily - one third of whom are women - was based in a unit on the grounds of Merlin Park Hospital for the past 26 years. However, due to a fire which caused extensive damage to the facility, it is currently accommodated in a temporary premises there. The proposal to move it permanently to the psychiatric unit has met with strong condemnation from service users.
They claim the move to this new location will result in the loss of privacy, ease of access and user friendliness and will “stigmatise” those for whom this alcohol and drug addiction counselling service is a “lifeline”. The centre has a higher than average number of women users. Last year 600 people, ranging in ages from 18 to 80 years, were referred to the service. About 50 per cent of the men and women presenting for counselling have alcohol problems. The rest have drug, both prescription and street, issues. Cannabis and prescription medicines are the main ones. Many clients have both alcohol and drug problems.
The proposed new premises at UHG is a purpose built secure unit for disturbed patients. Service users will have to walk through two wards to access the addiction counselling centre.
They fear too that people who have been drug and alcohol free thanks to the intervention of this service may relapse. One client says he knows of someone who has “broken out” already.
A number of service users contacted this newspaper to voice their concern. One woman called Sara sought help from the centre four years ago after moving from a social drinking habit to a more addictive pattern within months after being bullied at work. Her problem drinking began when she was aged 36 - she was drinking spirits daily at home.
“The [bullying] issue was never addressed,” she says. “In some ways I have to thank the individual responsible because they pushed me over the edge. I’ve been two years with the service in Merlin Park. It is located in an out of the way place, you can go there knowing you have confidentiality. I’m not ashamed but I am what I am. I’d be shunned if people knew. I don’t consider myself to be a psychiatric patient. I really cannot imagine the service being located to the new site, people won’t come there. You will have to walk through two wards to get to the room where the counselling will take place.
“While you can attend AA, this service is different. Joe and Nuala [the other counsellor] would know things about me that I wouldn’t discuss in AA. Joe is such a discreet man, so thoughtful and kind. The service he provides is really, really good. It has changed my life and is a major factor in me staying sober. If the service moves I won’t be going, it’s too public [at UHG]. By moving the service you are giving people who have enough on their plate another problem. They don’t need to be branded psychiatric patients. I don’t have words to describe how stupid the decision is.”
Tom, who is in his fifties and lives in Co Galway, says the private location of the service is one of the keys to its success. “No way will people go to the psychiatric unit. They are vulnerable enough if they are coming off drink. There is nothing wrong with mental illness but I’d have issues going into the psychiatric unit. If you are early in recovery it is easy to turn you off.”
A client of the centre for the past two years, he has been drinking since he was 15. “The discreet location, free parking, the anonymity and the counsellors who are 100 per cent make this an excellent service. It is a lifeline to many people. I credit it with keeping me sober. If I have a problem I can talk to the counsellors privately. That’s important because alcoholism affects more than the alcoholic, it has a serious ripple effect on families too.”
Anne, an alcoholic in her early forties who has been using the Merlin Park service for 20 years, says the “anonymity” provided by its current location is paramount to its success.
“Merlin is ideal, it’s so important the service is kept there. I first went there in 1998. I was very bad. It got me on the straight and narrow and saved my life. Joe Treacy has saved lives through the years.
“In the psychiatric unit you will have to pass by patients, there is a stigma attached. This will be especially true for younger people, they would be particularly embarrassed. They are concerned about their peers. Some of the young people who attend the service are in trouble with the law. This service reduces crime but I feel a lot of those won’t attend if it moves. There will be more people back on the streets on the drink. I’m a year sober now but I could see myself relapsing.”
New location will discourage clients
Senator Fidelma Healy Eames who is campaigning for the service to be retained at Merlin Park, says the HSE must answer a number of questions.
“Why relocate to an already overcrowded interim secure unit in GUH with no parking facilities and which does not encourage a user friendly concept of services? Why was there no discussion or dialogue with Mr Joe Treacy, the clinical specialist in addiction with more than 23 years service - his view was never sought on where the best location may be? Why in the worst recession of austerity we continue to downgrade and not develop addiction services? I am led to believe there are three addiction counsellors trained in Galway west and could easily be redeployed in the service – why can that not be done immediately? Merlin Park is a large campus with many empty buildings, most with very little maintenance required would be more suitable than the proposed interim secure unit. The addiction unit that was involved in the fire was heavily insured, what is the proposal with that insurance money, how is it to be used and what dialogue/discussion has taken place with stakeholders in the reconstruction of this service ie, mental health, GP’s, probation service, social work department, courts, family services and all other referral sources?”
She claims the new location will discourage people from addressing issues earlier as is hoped rather than later. “Earlier detection results in a better outcome. The continued increase of suicide in this country - 569 people took their lives in 2012 - with alcohol being a common factor, particularly in young people’s deaths, is a major concern. The cost of alcohol clean up for the west of Ireland for 2011 was €4 million while the number of bed days taken up in 2012 was 6,287 in Portiuncula, Galway and Roscommon.”
She claims that Joe Treacy, the addiction counsellor in Merlin Park, has received a disciplinary letter from the HSE advising him that his refusal to relocate to the interim secure unit in the psychiatric department will lead to a disciplinary procedure being taken against him. She says he believes moving the service is not in the best interest of his clients.
“This [proposed disciplinary] action by the HSE seems to be quite unreasonable and heavy handed to me given the popularity and satisfaction with the service in its current location.”
In a statement the HSE West said new arrangements for the delivery of mental health services for people with alcohol or substance abuse problems have been put in place following the fire at the addiction centre in Merlin Park on September 20.
Catherine Cunningham, the area manager for Galway/Roscommon community health services, outlined that services which previously were provided from the centre in Merlin Park are now being provided by community mental health services which is currently based in the department of psychiatry complex on the grounds of UHG.
“We are working to find an alternative base for the community mental health team as part of the reconfiguration of the Galway/Roscommon Mental Health Services which is currently under way. We are very conscious of the need for privacy by our clients.
“I’d also like to assure all clients of the service that the move from Merlin Park will not result in any reduction in the level of service provided. The alcohol/substance abuse counselling service provides outpatient treatment including individual assessment and counselling and group programmes. Access to the alcohol/substance abuse counselling service is now through the community mental health team.
“Under the auspices of the Haddington Road Agreement, we are seeking flexibility from staff in respect of relocating.”