To view original article click here
Tuesday, September 15, 2015
By Eoin English, Irish Examiner Reporter
The campaign, which aims to try to prevent future tragedies, may be dashed as a government-appointed expert group advise against a change in the law in relation to family involvement and the doctor-patient relationship, writes Eoin English.
BOTH mothers. Their lives torn apart by similar unimaginable tragedies. Both with the same plea for a change in the law they believe would spare other families their agonising heartache.
But it has emerged that the Government has accepted expert recommendations against changing the law.
Una Butler and Helen O’Driscoll have been through hell but have vowed to continue their campaigns.
Helen’s eldest son, Jonathan, stabbed his twin brothers, Patrick and Thomas, to death in the family home in Charleville in September 2014 before taking his own life.
Both men were engaged with psychiatric services.
John had been discharged from the care of the HSE just six weeks before he killed his daughters.
Jonathan had been battling depression, and had been diagnosed with early onset schizophrenia or psychosis. He had stopped taking his medication in the weeks before he killed his younger brothers.
But because of doctor patient confidentiality, their families were never told just how sick they were before the murder suicides.
The two women, who are campaigning separately for a change in the mental health act to allow for greater involvement of families in the care regime of people engaged with the psychiatric services, are facing an uphill battle.
An expert review group has recommended against changing the law to facilitate greater family involvement.
Mental Health Minister Kathleen Lynch said: “I understand the distress this may cause to Una and Helen but the very clear advice I’m getting from the experts is that it would be difficult to do this on a statutory footing.”
Ms Lynch ordered a review of the Mental Health Act and tasked the expert group with reviewing the law as it relates to electro shock therapy and the law around family involvement.
Ms Lynch, who has met with Ms Butler, said she asked the group to have particular regard to the Butler case.
The review, which took two years to complete, resulted in 164 recommendations which will, in time, lead to amendments to the law which will include the removal of the word “unwilling” from the legislation as it applies to ECT. However the group recommended no change to the law in relation to family involvement.
“The view is that for the majority of people in treatment, it’s voluntary, even if the first contact is involuntary,” Ms Lynch said. “And if a patient says to a doctor, ‘I don’t want anyone else to know’, the doctor does have to respect that. The concern is that if doctors don’t respect that, the person might not return for treatment.”
But she stressed that where a person expressed clear suicidal thoughts or thoughts about harming or killing others, then a psychiatrist was obliged to flag those concerns.
That need to flag concerns is particularly vital where young children may be involved, she said.
“In the event there is any indication about harm, where there is a possible danger or threat, the psychiatrists involved should try where possible to engage with a family member.
“But to put this on a statutory basis? They wouldn’t recommend that.”
AFTER years of pressing the HSE for a meaningful review of her husband’s case, Ms Butler finally received the findings last week.
The review concluded the tragedy was not preventable. However, Ms Butler expressed bitter disappointment that it failed to take on board her submissions calling for greater family involvement.
“It’s like beating on walls really,” she said. “I didn’t think or expect I would have to go through this to get a review from the HSE. I felt dismissed when John was under the care of the HSE and I have felt just as dismissed since the death of John and my two children.
“I thought there would be an automatic investigation into what happened, especially when you have two children murdered by their father who had suffered with his mental health.
“It was less than three months after he had been discharged from the care of the HSE that he killed Zoe and Ella.
“I’m still flabbergasted that there wasn’t an automatic investigation into it.
“I’ve had to bang on doors, write letters to politicians, I’ve gone to the Dáil and to the Mental Health Commission — all to get a review.
“There would have been more of an investigation if I stole a sandwich out of a shop — the guards would have been involved.
“But because my husband was the perpetrator, and because he died, the guard’s hands are tied. They’re not involved anymore.”
Ms Butler said she campaigned relentlessly for the review in the hope that it would help prevent further similar cases happening.
“It’s for the welfare of children. It’s a fright to God that I’ve had to do this. I’ve made a submission for changes to the Mental Health Act 2001, for legislation to be changed to involve partners, or close family members in the care of a person with mental illness.
“Since 2006, there has been a document called A Vision For Change which highlights that greater involvement of family members and carers is recommended but still nothing has been done.
“It cannot continue like this and if it does, I believe that there will be another tragedy. In order to prevent further cases from happening, we need to research and learn from them.
“These cases are being brushed under the carpet, they are not going to go away by not talking about them, we need to learn from them and in order to learn we need to research and investigate.
“I believe that medical professionals would have a greater insight into their patients’ behaviours if that was the case. This will benefit the patients and those around them. Regardless of the outcome of the review, I think the common-sense approach is for greater involvement of family members.
“I think it’s common sense to involve a family member of a person in the care of the psychiatric service. A patient goes in to the doctor and the doctor listens, and the patient tells the doctor what he wants them to know, but they are not hearing or seeing the full picture.
“A person does not live in isolation and should not be treated in isolation.
“There should be a family member involved, especially when there are children living under the same roof as the person suffering from mental ill health. The family should also be educated about the illness in order to understand it.
“I was proud of my children, Zoe and Ella, and I would want them to be proud of me. I believe their energy surrounds me but I am also very lucky to have a great family and very good friends that have been supportive and are always there for me to this day.
“I believe there are learnings to be had and to prevent other children, other innocent children, from being murdered.
“The unfortunate thing is I know I can never get Zoe and Ella back, so I’m doing it for them, and especially for the welfare of children, to try and help prevent further cases from happening.”
She praised her solicitor, Sinead Carroll of Ernest J Cantillon’s, for her help and support over the last four years. “I can understand somebody lying down and doing nothing. But you take one day at a time, and you just live for that day.
“There are days, lots of days, that you don’t feel like going outside the door. But you’ve no choice really.
“I put my trust in the health professionals and believe they tried their best. But they could have gained a greater insight.”
Ms Butler has been backed fully by Helen O’Driscoll, who also called for greater family involvement in the care of someone with mental illness after she heard harrowing details at a triple inquest last month of her sons’ final moments.
“We’re fighting the same battle. I didn’t know how sick Jonathan was. If I did, I wouldn’t have left him alone with the younger children. We would have been able to give him greater support.
“How many other families have to go through what we did? What are they waiting for? For the next family to go through this? Medication can only go so far. Parents, or partners, or somebody in the family, needs to know what is going on.”
Fine Gael TD Jerry Buttimer, chairman of the Oireachtas health committee, said there are no easy answers to what is a very difficult and complex issue.
“The doctor-patient confidentiality issue has to be respected but greater flexibility needs to be given to doctors to reach out to their patients’ wider family in an effort to prevent a catastrophic outcome,” he said.
He also said the calls from Ms Butler and Ms O’Driscoll would be explored with the minister when she is due to appear before the committee in November.