Facing down the faceless people

The faceless people in their fine suits are at it again. Maybe they’re right – but maybe they’re not. And we are well entitled to speculate that it might be the latter.

  In the Rosalie Unit in Castlerea, people with dementia and Alzheimers receive excellent care. The outcry over the possible closure of the facility by the HSE began earlier this year. Good sources ushered the story into the public domain. Good job.

  Since then, people from different sectors of the community have come forward to voice their fears. Public representatives, medical personnel, community leaders, all have had their say.

  Most powerfully of all, relatives of patients in the Rosalie Unit have voiced their fears. Their voices emotional, their words passionate, their fears real. The fear is that the faceless people in their fine suits aren’t in touch with reality; that aspirational strategies drawn up in city offices are threatening to supersede the logic as manifested on the ground, in the community.

  Put more bluntly, the fear is that elderly patients could be evicted from ‘Rosalie’, something which sounds heartless, ill-judged and cruel.

  Little wonder that the threat to the Rosalie Unit is the story that won’t go away. The community has taken ownership of the story.

  On Monday of this week, the Roscommon People asked the HSE to tell us just what the current position is. The HSE, in its response, assured us that the review of all mental health services in this county, which is currently underway, is motivated by what’s best for service-users.

  In a statement published in full in this week’s Roscommon People, the HSE seeks to assure the public that it will do what is right for Rosalie residents.

  You might assume therefore that we should not (further) question the powers-that-be. You might assume that we should place our faith in the review, in the HSE assurances. It may be that they are right to review and that they will be right every step of the way. But people are very sceptical.

  We’re sceptical because it is hard to trust the system. We could build a (paper) bridge from the Department of Health offices in Dublin to Castlerea with the volume of reports that have been launched in connection with the Irish health service over recent decades.

  It is a health service which, while brimming with wonderful front-line staff, is frequently in crisis and sometimes in chaos. It is a system which appears to be addicted to the wasting of resources and increasingly allergic to being accountable.

  It’s a health system which has often had to endure being kicked about as a giant political football – by short-sighted and sometimes shallow politicians. In Roscommon, we’ve a mental health service that seems to be under attack from its own masters at national level.

  And to those who might say that the resistance to the possibility of closure is more an emotional response than an entirely rational one, I return to the point about aspirational strategies not reflecting reality on the ground. I return to the point about faceless people in fine suits, these men and women who can sometimes adversely affect lives in rural Ireland largely because they have no proper sense of the complexities and contours of that very same rural Ireland.

  Very often, it seems to me, decisions are made by our faceless friends in Dublin or Galway which do not take proper account of local dynamics in counties like Roscommon.

  Dr. Greg Kelly is a highly-respected GP who is based in Castlerea. Strongly opposed to the closure of the Rosalie Unit at Áras Naomh Chaolain,, Dr. Kelly says some of the patients there have behavioural problems which could not be managed in nearby nursing homes. Can you imagine the anguish local families must feel in light of that warning? Does it resonate at all with the faceless people?

  In today’s Roscommon People, we publish an article by Dr. Charles Byrne, Consultant Psychiatrist at Roscommon County Hospital. Dr. Byrne, who refers patients to the Rosalie Unit, says that any proposal to “phase out” the facility baffles him. Closing Rosalie, he bluntly states, would be a tragic loss.

  There are reasons to be fearful. There is a lot at stake here. The mental health services in Roscommon are already in difficulty. It is not only ‘Rosalie’ that is under threat.

  Back in April of this year, Dr. Greg Kelly warned that many of the psychiatric hostels in County Roscommon are facing closure. Look what the HSE had to say on that subject…

  In its statement to the Roscommon People this week, the HSE says “There is no doubt that Galway/Roscommon Mental Health services have a high number of hostel and residential care provision…this is not about buildings or money, but what is the right thing to do.”

  Ominous reading, one might say.

  But perhaps it is about money. It may well be about money, given that the HSE policy is to reduce the number of residential facilities it operates. It may well be about money, given that we have seen the mental health services in Roscommon wilt due to shortage of staff.

  Or perhaps it is just aspirational guff which is lacking in joined up thinking, in which case it is reckless. Or perhaps it is actually okay in theory but utterly lacking in empathy for nervous, scared patients and their families. Perhaps what’s being considered looks okay ‘on paper’ in plush city offices, while not taking sufficient account of Roscommon’s increasingly elderly population and of other factors, not least the opinions of medical people ‘on the ground’ here.

  I don’t know all of the details/the full story/the possible agendas, regarding the threat to the Rosalie Unit.

  But, given a choice between faceless people in fine suits and Dr. Kelly and Dr. Byrne, I know where I’m placing my faith.