Irish Times: Care for those with intellectual disabilities
Dr Mary Kelly, Consultant Psychiatrist in Intellectual Disability and Dr Maria Dunne, Child and Adolescent Psychiatrist, this week wrote to The Irish Times to highlight the continuing closure of respite and day services for people with intellectual disabilities during the COVID-19 pandemic.
Unable to access these vital programmes, and without their normal routines and social interactions with friends and carers, these individuals and their families are now enduring severe stress. A marked increase in psychological distress also means that our already neglected Mental Health in ID services are struggling to cope.
These letters originally appeared in the Irish Times. You can read the originals here and here. Read the first letter by Seamus Cowman, Professor Emeritus of the Royal College of Surgeons here.
Sir, – I would like to echo Prof Seamus Cowman’s strong and passionate letter (December 9th) highlighting the current lack of day and respite services for people with intellectual disability and their families, which has become much worse since the Covid -19 pandemic.
Disability day and respite services in many areas are either closed or are not functioning at their previous capacity, which is having a seriously detrimental effect on people with intellectual disability and their families.
As a consultant adult psychiatrist in intellectual disability for the past 28 years, I have seen an increase in depression and anxiety disorders, psychosis, and severe challenging behaviours, including serious assaults, in my patients which is directly related to the curtailment of day and respite services.
Many have parents or siblings who have serious health problems themselves, or in many cases are frail and elderly.
One father told me he has bought locks for every room in his house to keep him safe from his adult disabled son, since the Covid-19 pandemic started.
Another parent spends hours driving his adult son around the city when he is finished work in the evenings to reduce his son’s anxiety and aggression.
For many people with intellectual disability, their entire social lives are based in and around their day services, their friendships, activities, their routine, and many of them cannot understand why it has been taken from them.
Mental health services for people with intellectual disability remain regrettably seriously deficient in Ireland. Covid-19 has exacerbated this.
The development of mental health teams in intellectual disability (MHID) was proposed in the HSE document Vision for Change in 2006 for the first time. This was a very exciting prospect for people with intellectual disability and for their families and the dedicated staff working in this area. Regrettably, many areas and many counties still have no MHID teams, and in addition there are no specialist psychiatric in-patient beds in the entire country for people with intellectual disability.
Progress and development are at a snail’s pace, and that is causing many serious problems to people with disabilities, their families and the very dedicated staff who work in this area, many of whom are at risk of burnout.
Ireland should do better than this. – Yours, etc,
Dr MARY KELLY,
Sir, – Dr Mary Kelly, Consultant Adult Psychiatrist in Intellectual Disability (Letters, December 13th) expresses concern about the reduction in day and respite services for adults with intellectual disability, outlines the impact on the mental health and adaptive functioning of service users and emphasises the burden family and professional carers bear as a result. I echo her concerns.
In the same edition of The Irish Times a number of reporters inform on the views of primary, secondary and third-level students and their teachers as they continue with education in the midst of the pandemic.
I am struck that the voices of children and adolescents with intellectual disabilities – and their teachers – are absent.
Some of these pupils attend mainstream school, many others attend special schools. Some cannot access school places at all.
The challenge for those with intellectual disabilities to have their needs recognised and addressed all too often starts in childhood.
They and their families struggle to access early assessments, appropriate multidisciplinary services, educational and training opportunities, day and respite services and medical and mental health services.
This worsens as they become adults.
We should do better for children and adults with intellectual disability: perhaps we start by recognising and including their experiences. – Yours, etc,
Dr MARIA DUNNE,
Consultant child and