Ciaran

I hadn’t seen in him in years, but I knew something was wrong with my unmarried uncle Brian when I met him at a family funeral. He’d always dressed well in expensive clothes, changed every day, was presentable, even when he was drinking; now his clothes were dirty, he seemed to be drooling – he looked like a “down and out”.

I found out that another uncle had brought him to an accident and emergency one time, when he was in a bad way, but they simply sent him home again with a consultant appointment for six months time. I decided to see what I could do to help. I’m a business professional, so I’m used to making things happen. It wouldn’t be hard for me to lend a helping hand, surely? B’ amadán mé (I was a fool).

I soon learnt, in our health services, nothing happens quickly and different professions don’t talk to each other. If you have a mental health illness combined with addiction,you’re probably doomed. Trying to organise a case conference where you get all the health professionals in the same room is like pulling teeth. You have to keep ringing, writing, emailing, complaining, keep detailed records,and complain to the Ombudsman before you get anywhere. I must have heard “can you ring back…” hundreds of time.

Uncle Brian was a complicated case as he had a previous brain injury. It was one from which he had fully recovered; he had even gone back to work. Despite giving up alcohol over 15 years ago, he still suffered from cravings and found it really difficult staying off drink. Part of the problem in staying off the drink was his depression. He had been on antidepressants for over 20 years. In all that time he apparently had never seen a counsellor, just psychiatrists, for five minutes every now and then to review his prescriptions.

He’d gotten off the drink with the help of AA, but he never stopped worrying about starting drinking again; the temptation, the urges, they never left him. I found out from a doctor that he had spent a month in a mental hospital, which no one had known about. He was too ashamed to tell anyone, even the people that loved him most, and yet the government still think it’s ok to move the mental hospital right next door to a prison!

We paid privately for him to see a highly recommended psychiatrist, to look at coming off all his medication. The psychiatrist was a nice man, but the service he provided was not satisfactory, he took two phone calls during the session as he questioned Uncle Brian on intimate life details and his personal history. So much for the values in the Government’s “vision for change” of “respect” and “person centred” priorities!
When the boss changed in work, Uncle Brian could not cope with the new bosses style, he got too stressed and he left on disability. Life went downhill from there. When we eventually got him into hospital his condition had become very bad and he often appeared comatose.

But then, so would I, if the nurses thought I was deaf, and kept putting on a mask to shout right into in my ear, because I had not answered them quickly enough!

Another thing we discovered over the course of seeking proper treatment for Brian is that anybody can call themselves a psychotherapist, there’s no government licensing. However, eventually we found a qualified private psychotherapist and Uncle Brian started to make progress.

As time went on I got to know a lot more about Uncle Brian. Labelled by the mental health services as “paranoid”, I knew him as a sensitive, gentle, intelligent man. Despite leaving school unable to read, he now enjoyed reading and poetry; Patrick Kavanagh was his favourite. He could discuss politics and any kind of music you’d mention. Because of his rough time at school and home, he was really scared he was “a bad person who was going to hell.” In all his time in the mental health services, this belief had never been challenged or addressed. It’s easier to throw drugs at people, despite it costing more in the long term.

Despite improving mentally, physically Uncle Brian got worse. It turned out he had cancer. We were very lucky though, because we got him into the hospice. In dying, he and our family were treated with respect, dignity and compassion. The relief of being listened to and our concerns being dealt with was fantastic. It was the type of support that we and Uncle Brian had looked for, but never found, when he was in the mainstream health services.

I wonder though would Uncle Brian still be alive today if he had received that type of service all along? How different would the quality of his life have been?

Uncle Brian died last December aged 62. Most of his life was spent struggling with depression and alcoholism.

Uncle Brian was fortunate; he had three different members of his family fighting for him who could provide money, plus the support of his extended family. Yet we became exhausted and my own business suffered, because I had to spend so much time chasing around the health systems. What happens to the people who don’t have some one who knows their way around the health service fighting their corner? I guess they end up on the street or maybe they just die.

With the help of AA Uncle Brian generally stayed off the drink, but his depression and anxiety never got treated and I believe these problems caused his physical illness and his constant tough battle to stay off the drink. Apparently there are links between alcohol addiction, brain injury, depression and anxiety yet our health services treat these separately. You have to fit into their boxes, but with Uncle Brian it was like trying to fit a square peg into a round hole.

We never heard the words “dual diagnosis” and it’s only now, with Uncle Brian dead, that I have the time to investigate and understand what it means. In Ireland, dual diagnosis means you go from Billy to Jack and never really get a service that helps you. That’s what happened to Uncle Brian.

So maybe reading this, you’ll understand why I am sickened that two TD’s on salaries of €100,000 got paid €53,000 each for losing their junior ministries as so called “embarrassment money”. We were embarrassed that we had to send begging letters to top health officials, so Uncle Brian could spend some weeks at home, with support from a home help, as he wanted, before he went to the hospice. Did we get compensated?

€53,000 is over 700 psychotherapy sessions, a service that was not made available to Uncle Brian. How many other people have to die or have blighted lives before we are embarrassed enough to put a decent mental health service before compensating already well paid politicians?