My paper to the recent Irish Institute of Mental Health Nursing

In Uncategorized on June 7, 2011 at 8:24 am

Irish Institute of Mental Health Nursing2nd Annual Symposium
2 June 2011 from 9.30 – 4.00
Room B0005, School of Nursing and Midwifery, Health Science Building, University College Dublin, Belfield Campus

Keynote Address:
Do doctors have the capacity to decide?
In the equality debate, nurses must step up to the plate!

John McCarthy, social entrepreneur, mental health campaigner, poet, author, columnist, WNUSP & Mindfreedom delegate to the UN CRPD 2006, award winning documentary maker and founder of Mad Pride Ireland

John McCarthy founder of Mad Pride Ireland
Do doctors have the capacity to decide? In the equality debate, nurses must step up to the plate!

Presented: UCD School of Nursing and Midwifery – July 2nd 2011


“When I was a boy of fourteen my father was so ignorant, I could hardly stand to have the old man around. But when I got to be twenty-one I was astonished by how much he had learned in seven years.”
Mark Twain.

The last time I addressed as large a gathering of psychiatric nurses as this, I gate-crashed a conference in the Rochestown Park Hotel in 2005 and grabbed the mike. Let’s explore how much we have all learned since that event in Cork shall we.

This paper does not conform to academic standards; it is the result of ten years subjective research. Research based more on listening than reading. A different type of paper, but a research paper none the less. Please listen with openness and begin judgment at the end of the presentation rather than the beginning. The very deliberate intention of this paper is not to address medical treatments as to whether they work or not but the morality of putting legal force behind the use of these medical treatments.
This is not a popularity contest I come here today be challenge you all, to those who facilitated that right to challenge and engage with me as an equal citizen I thank them from my heart.

Law, Language and Human Rights


“I am not interested in picking up crumbs of compassion thrown from the table of someone who considers himself my master. I want the full menu of rights.” Archbishop Desmond Tutu.


We the mad community demand the full menu of human rights under law but not as a gift granted by an ethos that portrays opinion as science.

In Ireland we address stigma and ignore discrimination. We change policy and reinforce abuse. We pander to equality while we deny civil and human rights to a section of Irish society, the mad community.


As exampled by the kindness of Amnesty arriving in the Dail to warn Senators about those at risk if we did not have the use of force in place; for certain “vulnerable patients” at certain times. This “in the patients best interest” of course!

Amnesty simply cannot imagine that leap of faith needed to declare women equal to men, black equal to white, gay to straight.

The mad community, as an equal part of the community, with all the rights, privileges, and responsibilities that implies!


I “developed mental illness” as a consequence of a dysfunctional childhood and a collapsing business. Those who develop physical illness get well, lead full lives and they are not permanently branded as disabled. I had an emotional collapse of the spirit not the brain. Genetics is now going back to research to try and find the gene for mind and spirit.

 I was at the negative side of madness for a time. I learned a great deal from that experience; it improved my life immeasurably.

Yet that learning experience has made me in legal terms a second-class citizen of Ireland, “disabled by a label” for life.


Article 3 of the Mental Health Act 2001 legally defines me

And I quote

“(1) In this Act “mental disorder” means mental illness, severe dementia or severe intellectual disability”

How can we build trust if we believe that my legal capacity is defined in the same legal space as a fellow human being with severe dementia? So many in this debate do not know the legal implications in accepting these two terms, “mental illness” and “mental disorder”,  to mean the same in law. Those words “mental disorder” so often juxtaposed with “mental illness” so that in the public’s mind they are blurred.


Justice is about fundamental freedoms, human rights are not to be judged by doctor’s opinion, but by objective dispassionate judicial review. Liberty and freedom are a precious gift, every citizen’s right, capacity to judge that right and privilege is beyond the remit of medicine.

If you enter debate on human rights as strong women did in their fight for equal rights, if you have a core principal – i.e. full equal human rights for woman – you do not bend on that core principal.

You do agree to engage with all parties within the debate to design the most flexible method to achieve the core principal.



A satisfactory outcome rarely involves an ideal solution, but rather a compromise that allows everyone to move forward”.

DR Tony Bates Irish Times.



So very often sitting at the table of compromise is nothing more than polite conversation that repeats kind/improved policy that disguises old abuse.

We the mad community can compromise on politics, not on human rights. Compromise has a place at the table of policy not at the table of rights.



We the mad community are different, that is our gift and our cross. Society can choose to fear that difference or to celebrate it.

We are the least violent members of society, as established by recent Harvard study, yet the most feared.


I am challenged as to who are the mad community. We are all of you, none of you; we are forced by ignorance to be invisible in society. Would you openly declare yourself Christian in ancient Rome, Jew in Nazi Germany, Catholic in penal Ireland, and Protestant in Catholic France? Gay in 1960’s Ireland.


History is riddled with examples of people who were abused by unjust law; being forced to be invisible, to hide who you are, to survive society’s ignorant prejudicial opinion.

“I am mad”, put that on your resume either as “mental illness” or madness!


We, the mad community, are fellow citizens, nothing more – nothing less. All emotional people are mad, therefore we are all mad, which is perfectly normal. We all experience the negative/positive sides of madness for a time; it is why we are human.

The “mental disorder” lies in the propagandized mass thinking of society.


We must have a level, deep and uplifting debate on legal capacity, mental health acts, human rights laws, but from a starting point that agrees that we the mad community are equal citizens. The onus in this debate must switch onto medical science to prove that the chemical imbalance theory is scientific fact, that we the mad community have a treatable disease of the brain. It is not for the mad community to prove that we do not.


We, the mad community, must sit with equality at that round table and speak for ourselves at that table. We need advisors not spokespersons. Few in the area of mental health have a greater claim to expertise than the mad community. We will share that expertise with those who respect that expertise, and we will not with those who pay lip service to that expertise.


Out of the Vision for Change, we have a hybrid of the result of kindness replacing rights. The National Services Users Executive, a mix of the mad and carer voices, as if both could express their distinctive needs with one opinion. The recent awards ceremony, organized by NSUE, to recognize/reward “good” psych services, while we still have people locked away for the whole of their lives, the perfect example of this equivocal thinking. That ceremony was a sham and a shame, and is being recognized as such.

The Mental Health Commission slated conditions in some psychiatric units Ireland in 2010, as did the EU commission on Torture in 2010.

This from John Redican the CEO of NSUE re the same services:


“We are hopeful that the good practices unearthed by our survey will lead to their adoption elsewhere.”


Others are trying to develop a human rights-based policy (Amnesty et al) within a legal framework that is abusive. That is gross stupidity.


Further we are diverted into the status quo beliefs that come up with a policy like See Change to challenge stigma, instead of rights.

We are spending millions organizing meetings for like minded people who have an entrenched opinion to meet together, have a polite conversation about what should be done to improve services. Most gross of all, be satisfied when citizens who experienced the system, shaking and shivering while speaking at these meetings as victims!

 See Change leaves, congratulating themselves for giving these “victims” that space, and report this “progress” back to funders. While they never speak to the reality of abuse, to the law, as an instrument of abuse!

 When I see, See Change ask to host a meeting in a lock up psychiatric ward and open that meeting to the public and media, allow the locked up, free access to the mike, then I will believe they really want to see change.


God, there is so much doom and gloom around the topic of madness it would depress you to be listening to it.



“Against the assault of laughter nothing can stand.”

Mark Twain again, I would love to have met that fella!


Strong Radical thought is fighting such an uphill battle to find equal space at the table in this debate.

But we are getting there. We are getting there through Mad Pride Ireland Family Fun Days; no protests, no information leaflets, just the opportunity to laugh and love, so complicated, really!

 We expect 15,000 in Cork, with Kila headlining a free family fun day in Cork next Sunday.


That by the way was an ad break.


It gives me great pleasure to announce today that Mad Pride Ireland has secured funding from Denis O’Brien to launch a nationwide publicity campaign in the autumn to raise public awareness on the subject of persistent breeches of human rights as part of a wider debate.  The media is now looking at the normality of madness through a different lens, because we have introduced the positive side of madness as a serious issue in this debate. With a child smiling, teenagers dancing with delight, parents relaxing, and grandparents blackguarding, at a Mad Pride family event. Simple fun, no fear, no need!


We are getting there in debate on the delete 59b, the forced ECT campaign, where academia, psychiatry, and the mad debate as equals, disagree frequently, but never stop talking. No funding applied for or needed. Goodwill and voluntary effort, so effective, our time and heart, love, the basic ingredient! Yet, we brought that debate to the Oireachtas floor.


We are getting there through the newly founded Critical Voices Network. No budget, again people’s time and love. No chair, no committee, no employees; we simply created a space to speak. So effective!


Such a relief to go to a forum where titles are left outside, expertise judged on what you do and say, rather than how many books you have read. Respect is the keynote speaker, love the key ingredient, people speaking as equals, no experts or victims present, please get involved, our doors and our minds are always open.

We have a new government and a new junior Minister in Kathleen Lynch TD. Will they step up to the plate?



Let’s talk about Secrecy and Abuse

In order to progress we must know the facts, all of them: who prescribes, what, where, when, and how much.

There is a positive role played by drugs in the entire sphere of modern healthcare , this is true.

But we must keep records of those adversely affected by any treatments.

Open files to neutral parties.

Remove the power of the medical model to hide behind silence and secrecy “in the patient’s best interest”.

We must insist that the suicide prevention office track and highlight the part played by legally prescribed medications in the deaths of our loved ones.

We must insist that coroner’s report and highlight the level of legally prescribed psychotropic drugs in the victims of suicide at inquest and who prescribed them.

We must question the over-influence of the pharmaceutical industry in the debate on Mental Health, and how they promote “mental illness” as a commercial profitable medical industry.

We must question the over-influence of the pharmaceutical industry in third level education.

We must question the over-influence of the pharmaceutical industry in psychiatry, and on our doctors and GPs.

We must question the right of psychiatry to be judge and jury.


When children were born to unmarried mothers we called them bastards and the church gained great kudos for “taking on” these unloved and stigmatized members of society. That is not say all bastards were abused or that all clergy abused them but it took years for the shocking truth to emerge and thousands of lives were ruined by an ignorant Irish society, and the silence of those who worked in that abusive system.


We were ashamed of those innocents.

Sound familiar.


Psychiatry is assuming a position as a new moral voice. They are doctors, nothing more; they should stick to the day job.

We run to hospital when we are physically sick, we have to be forced “into care” in psych units when the negative side of madness appears.




 The pharmaceutical giants and the doctors on their payrolls are poisoning too much of the medical science


Ray Moynihan


Who profits from all this and at what cost in human misery?


Are Mental Health Nurses Agents of social control?



Proctor 2005 p.280

“that in mopping up problems, clinical psychology preserves its status power and status quo of inequalities which in turn perpetuates the creation of distressed people”


Radical thought in this debate is one that would suggest that in the area of treatment of the normality of madness. We should turn from force to love.

To train nurses to hold me when I need to be told I will be ok because they will care about me, not just for me.

To turn fear, caution, force into care, love and compassion, where I always understood nursing came from.



May I introduce the following as possible questions for the ensuing debate?

Is over-medication abuse?

Is forced medication abuse?

Is the use of ECT, when free and informed consent is obtained while the patient is heavily sedated, abuse?

Is forced ECT abuse?


Other questions that deserve answers:


Is denying citizens the protection of the common law abuse?

Is a diagnosis without qualifying scientific test abuse?

Is objectifying human beings as legal second-class citizens abuse?

Is holding tribunals in secret, as a protection of the “vulnerable patient” abuse?

 (93% of psychiatric opinion is upheld in tribunals)  

Is locking away victims of rape for 60 years because their behavior changed abuse?


Consider this:

 Larry Murphy as a rapist, did he have a “mental illness”? He was given his freedom based on “good behavior” and his right to refuse treatment in gaol was rightly protected by the common law.


Media and whistleblowers where are they:

Where are the media? Where are the hidden cameras as in Leas Cross?

Is the fourth estate, with emerging honorable exceptions negligent as a functioning part of the state when it comes to its responsibility to the voiceless abused in psychiatric units.

Where is the law, where is justice, where are the whistleblowers?

Those who see abuse and who remain silent inside that system are abusers.


Those who feed their children from this abuse must find the moral courage to step up to the plate!


When you address the issue of abuse in the context of psychiatric units, we who are trying open a debate on this are subjected to exactly the same treatment in the public domain as those who first spoke about child abuse. The institution is protected, just like the church was protected and this denial creates new victims.

The press afraid of libel laws; hides behind that fear. Until one brave member like Mary Raftery reports the truth, and then the floodgates opened.

Watch this space as they say.


Like child abuse those working in the areas where abuse took place protected their jobs to protect their own families.

There are so many reports of complaints and so many voices being raised speaking of their personal abuse, how can we not have national outrage?


Society must find the moral courage and compass to step up to the plate!




Let’s talk of nurses propagandized into not realizing they are gaolers:


Using semantics to disguise real cruelty in the public domain; language invented by academics to train students to carry out abuse and disguise it as caring speak:


Like the following phrases;


Assisted admission is locking citizens away based on their behavior but not having broken any law. Based on the fact that, that person in someone’s opinion might, please note the legal power granted to that word might,

“might be a danger to themselves or to others”.


Does the patient lacks insight mean the citizen is saying No to treatment and disagreeing with diagnoses?


The patient is showing insight does this means the patient is so drugged up he can no longer disagree or care what happens. They are compliant under control!

Nutrition enhancement is still force feeding no matter what you call it.

Time out, seclusion is still solitary confinement.


Nurses observe patients develop the following known side effects of certain psychotropic drugs, Tardive Dyskensia (the shakes) and Akathisia (that terrible restlessness that causes the patient to pace up and down), classically shown in movies to portray the mad as creatures to be feared while nurses struggle to control them. Obesity, diabetes, heart disease, suicide, the list goes on.  



Richard Lakeman et al 2007.

“The position of those who use mental health services in society has deteriorated (Campbell 2001) and despite the apparent improvements in biomedical treatment, people diagnosed with schizophrenia today are twenty times more likely to die by suicide than those diagnosed 100 years ago (Healy et al 2006, Seeman 2007).”


Yet nurses force these “medications” on those in their care?


Dr Phil Barker Mental Health Ethics Tony Warne et al state:

“For some mental health nurses ensuring that services users have a voice and are enabled to articulate this will bring them into conflict with not only the organizations that employ them, but also the policy makers that shape and performance manage these organizations”


Let’s look at a little history:


From Mark Finnane, Insanity and the Insane in Post Famine Ireland:

John Connolly writing in 1840:


“The attendants were to conform to the dictates of the institution – they were to study and obey the elaborate rules of the asylum.”

And again:

“Yet the morality of moral treatment was not relative but absolute-cleanliness, order, right habits, the expulsion of bad thoughts and the inculcation of the right ones … the increasing permanence of the ‘chronics’ meant the priority of institutional values  and absolute standards of behavior over individual treatment.”


Does that sound familiar to anyone?

Attendants, rebranded psychiatric nurses, now rebranded mental health nurses, were in the 1840s being warned/instructed that the rules of the system came before the patient “in the patients best interest”. In 171 years, you tell me what has changed, outside of the color of the paint?


From the same book:


“Another doctor, reviewing the long-stay male inmates in 1898, found a 56-year old former laborer who had been admitted in 1880 ‘quite rational’. But his account of their interchange expressed surprise at the man’s attitude.


That doctor in 1880 said the following;


“He is discontented for being kept here so long and becomes a little irritable and cynical if one suggests that he ought to like being here as he is treated so well.”


Jasus, we the mad community, despite being “quite rational” were ungrateful/lacked insight regarding force in 1880, and we are still ungrateful in 2011, but is anybody really listening even now?

Being ungrateful for being abused; is that a new disorder?


We, all of us, must change if we are to progress, but nurses have a special place in the hearts of the public, that makes you huge agents for change. Stop your representative Mr Des Kavanagh complaining about your pay and conditions, using fear as a negotiating tool. That does you NO honor.

Refocus your hearts and efforts, on your patient’s rights and conditions; join in the campaign to highlight human rights abuse with Mad Pride, CVN and others, all our lives will improve together.


Your working conditions, your patients living conditions they are the same


place, some of you are as institutionalized as your patients, we could become


free together.



The Medical Model

In 2006 when Tim O’Malley Junior Minister for Health, a pharmacist, raised questions regarding  “mental illness” and prescribing, attempted to raise a debate around the holy grail of psychiatry, six teaching professors of Psychiatry called on him to consider his position.

Fear of consequence in asking questions again raising its head “in the patient’s best interest”.


Are those promoting the status quo and the medical model actually engaged in a negative campaign, using fear of consequence as a weapon? 

The medical model of psychiatric force use fear of consequence as evidence in courts and tribunals. The “doctors knows best” becomes “what if”. “What if” the doctor is right and this person “might” be a danger to himself or others “What if” the patient does “something” if I let him out. Fear of consequence “might” as proof now the modern version of “guilty” in the courts of justice for the mad community.


We, the mad community, are seeking a peaceful resolution in this debate. The violence is all coming from the status quo medical model with its demand for  the right to force treat.



“It is so much easier to know what you are against then what you are for.” Damien O’Donovan. The Wind that Shakes the Barley.


That is so true in the area of Mental Health, so easy to condemn the status quo medical model, overreliance on meds and force, all it implies, the challenge is always what we do instead.

We must find a round table that will seat all equally, pro med and anti med, at that same round table. So we can talk and build respect over time, find a rights, not policy-based solution. So often the Mad Community are excluded from that table because they cannot afford the price of a train and a lunch.


While the status quo medical model have unlimited expense accounts!


This, I suggest, is a golden opportunity for our new junior minister Kathleen Lynch and her officials, she has the authority to order this table to go into manufacture; I hope she meets the challenge.


Have John Saunders, John Redican, Angela Kerins et al, reached their sell by date? Is it time for fresh thinking to head up this debate? Some believe that it is.

Quangos brought about the economic ruin of Ireland. Compliant economic spokespersons put the job before the uncomfortable truth.  


I could suggest the following as alternatives worthy of serious debate; out of that debate we may find a real solution.


Take the power of doctors to take our freedom out of the law.

Examine how the system would operate without legal force.


Have help lines that respond to isolation and loneliness, these two at the heart of the negative side of madness. Help lines that, like lifeboats, are manned by trained sailors who respond, not fearing the dangerous sea; who when someone is drowning emotionally go to the home of that lonely human being,  sit through the night with them with love, as in the AA, alcoholics respond to alcoholics, from empathy and understanding comes strength. How radical.


I know of nobody with madness who does not feel the approach of madness; the itchy felling at the back of the neck, the black dog always growls before he bites. Yet we have evolved a system that waits for the crisis to emerge before they intervene. What if we had safe houses staffed by the mad community? We have a total empathy with each other, where you go to, and look to, being held before the crisis arrives. Where anger is not feared but understood, where aggression is not tolerated, where bad behavior is neither condoned nor judged. How radical.

But a word of caution. The notion of early intervention is already being hi-jacked by the lads with the pills. I listened to a psychiatrist give the following advice an EU summit on mental health in Brussels stating we need to “test” and “treat” our children at early age for ADHD as a matter of urgency and they locked me up!

Let it also be stated that I listened to many other emerging psychiatrists’ voices who are bravely stating that their profession is over influenced by the pharmaceutical industry and are willing to engage in open debate on legal capacity.


We must all step to the plate.


What if the mad community were subject to the common law and unable to hide behind innocent by reason of insanity? 

What if the mad community went to gaol when they break the law?

Many of my friends in the mad community abuse the learned behavior from a system that states the disease is at fault and excuses rudeness, insult, aggression; takes away responsibility.

The responsibility for our own actions is diminished by buying into the system. The system conveniently tells us it is “the illness, the disease in your brain”, give us more pills and we wander home again.

Many of us in the mad community become addicted to being helpless and hopeless. When you lose control of your emotions and fall into a system that tells you that you have an illness, a disease of the brain, a disability for life that you cannot recover from, it can be so comforting.

The mad community must find the moral courage and compass to step up to the plate!

The mad community have to stop being invisible victims and stand out as visible honored equal citizens. You earn your own respect.

But the status quo opinion is entrenched in the hearts and minds of those in power in this state, and they, that nebulous status quo, have unlimited funds to push and reinforce that entrenched opinion, which uses fear as its core message.

It would take a grand cooperative effort, to change that core message from one of fear to love. We have started that campaign. You as organized official mental health nursing can decide to join us, begin by  supporting the campaign to stop forced ECT, remember, just forced ECT, as is presently legally undertaken, this abuse protected by the wording of 59b of the mental health 2001.

We must delete59b from the act, what kind of an idiot is willing to remove the word “unwilling” while retaining the word “unable”, only an idiot would expect praise or self congratulate and state this is real change.

Compromise of rights again raising its ugly head!

Minister Kathleen Lynch must step up to the plate.



The value of a good relative cannot be overestimated or overstated.

The damage caused by a bad relative cannot be understated or underestimated.

This topic is a minefield of indignation, and questioning/challenging in this arena is so often perceived as ingratitude. But the responsibility of physical and, even more damaging, emotional family abuse must be the subject of a wider national debate.

So very often those family members that carried out abuse in the first place are the family members that sign the papers to lock up the very family member they abused, because the abused family members behavior is now too odd for them to live with. And the system accommodates that further abuse.


“the psychologisation of distress firmly places the cause for psychological ill-health within the individual. Thus depredation, abuse, oppression the social and political context of distress can be largely ignored and the practice of clinical psychology can continue to mop up problems caused by a sick society” Proctor 2005 p. 280.

 With the present regime and range of services available to relatives, when they are faced with stark reality, it is a horrible judgment call to sign those papers.

I have so many friends who are relatives in despair for the lack of correct help. Fight for their loved ones outside the status quo, and I meet so many others who are at the opposite end of the paternalist scale, who accept the comfort of the “mental illness” label as excuse to not fight for real change, who glory in the role of parental victimhood promoted by so many voluntary agencies as relatives representatives, and thrive on the comment “ye poor thing you were sent an awful trial”.

At an aware meeting recently a man introduced himself

“Hi I am a sufferer, are you?”

This stated as a fact in Shine literature;

“Schizophrenia is not caused by bad parenting.” 

How can they possibly know this as fact!


Consider this statement if it came from the mad community.

“Schizophrenia is caused by bad parenting!”  

How would Shine react to that stigmatizing remark, on behalf of parents?

Please listen to RTE doconone Lives Less Lived, Liam O’Brien and John McCarthy.

The true story told by the victim of rape and her brother, tracing the life of this young woman raped at seventeen and locked away by her parents, diagnosed manic depressive, her rape and subsequent distress became a convenient disease of the brain, forgotten by most of her siblings, still alive, never got out at seventy six, still being “protected”, cared for by the caring psychiatric system in Ireland in 2011.

You would have to ask how many generations of psychiatric nurses in sixty years “cared” for this lonely ashamed victim of rape; she told us they forced fed her, forced ECT on her, forced medications on her, restrained her, put her in solitary confinement, she states they beat her, this Irish girl/old woman never committed a crime. She told the nurses she wanted to go home and generations of psychiatric nurses reared their own families on the reality of this lady’s misery.

Art.13 of the Mental Health still empowering arresting Gardai to bypass courts judge jury bail a fair trial, for Irish citizens, based on opinion of odd behavior.


Where is the Human Rights commission? When I approached them I was referred by the then chair Mr. Maurice Manning to the consultant psychiatrist on their board, Mr. Bob Daly.  Silence. I rest my case.

I spoke of 59b to Mr Eamon Moloney in GF CUH. He told me to redirect my efforts to raising funds so he could run a better service. I was good at that he told me.


I lodged a petition with the petitions committee at EU. Silence.

The U.N. rapporteur silence.

The Bishop of Cork John Buckley after my visit to the palace. Silence.

So many politicians, silence with wonderful honorable exceptions

Memories of the Murphy and Ryan reports and the passing of the buck!


Families must challenge diagnoses without scientific test. Would you let a loved one go for brain surgery without test?

Families must accept that some psychotropic drugs are addictive, and rigorously question the prescription.

Families must question the treatment regime of overmedication that keeps a loved one compliant.

Families must find the moral courage and compass to step up to the plate!


 When sudden acts of violence occur the system failure is again blamed on lack of resources.

The system not being effective, because of the lack of money, nothing to do with false ideology! If the system had more state money we could cure everything, they state. If there is any area of health in this country that deserves spending cuts it is mental health. At least cancer is showing improved results, the pill for every ill consortium is killing people, we should shut down the funding tap to this failed system, until we see real change.


We must cleanse the past sins of the psychiatric forced care system in order to build a future loving system based on the equality of all human rights.




“That crazy bastard might be the only sane one left” – Dr Stubbs, speaking of Yossarian, in Joseph Heller’s Catch-22.


I was an active member of the mainstream business community in Cork, member of all the right clubs, drank and ate with people of influence, pretension so much more important than intention. I had a three piece suit and a briefcase, a dream existence, a nightmare, I hated it inside.

I was so discontented internally, so jolly externally, as so many are.

I am an ex male chauvinist, taught all my life to love my neighbor but never taught to love myself.

I have learned the value and power of unselfish love of self through the positive gift of madness. If I spoke that simple statement in my old haunt at the bar I would have thrown out of the gang and locked up as mad!!

When the notion of Recovery first started to whiz around the status quo merry go round, I embraced it, great idea, when you are desperate you will buy/try anything .

I have not recovered, I never want to recover, I hate the notion, why would I want to go back to when I was recognized by society as “normal”, when I conformed despite all the inner turmoil that conformity caused me!

The self-doubt, lack of unconditional love of self I had all my life! 

No, I discovered the beautiful joyous, peaceful and creative side to madness, why would I want to recover and give back all the gifts that being at peace with madness bestows on me and my family’s lives!

There is great peace to be gained from understood madness.

Jesus, we are told, went into isolation in the desert, saw visions, heard voices, spoke to God and heard the answer. By today’s standard of DSM Jesus in hearing that answer was a paranoid schizophrenic, and would most certainly be forced by kind psychiatric nurses obeying his doctor to take depots of Haldol, after involuntary ECT, unless of course Jesus admitted he lacked insight.

I am frequently asked, does what you propose exist in any other jurisdiction, the answer, No, not completely but Ireland can be the first. But I would direct you to Finland, they are beginning to look at a new drug free way, to Berlin where the Runaway House has provided sanctuary for many in a non judgmental way, to the revival of the Soteria experiment in Alaska, Healing Homes in Sweden, there are many others. It is beginning.


Might I be so bold as to suggest a proposal to be put to this house today in this debate that the first multi-disciplinary team be established led by a senior mental health nurse who cannot prescribe and that the doctors on that team must consult before any prescription be written, and only written as a last resort after full discussion with the entire team including the patient or their representative nominated by legal advanced directive, re a different solution outside medication.

That psychiatry find a place in the team but not at the head of it. Psychiatry has lost the right and the moral imperative to lead, psychiatry must step back and learn to be led, it would be good for the entire profession of psychiatry, especially forensic /forced psychiatry and child psychiatry, to go back to the heart and out of the head. Psychiatry needs to go back to its root.

Psychiatry from the Greek means healer of the soul/mind, no mention of the brain. You as nurses must help the lost souls in psychiatry to find peace; it is your duty as carers.


New-age Irish mental health nursing could lead this break from the exclusive overreliance, over influence, of drugs and medical opinion; it is time for new thinking, new attitudes within and outside of the old outdated system that dictates the doctor knows best.

Of all the areas of health, in mental health that statement “doctor knows best” is so blatantly not true. In mental health we need listening ears and time to use them, not the fastest pen in the west mentality. Traditional nursing practice of nurturing the patient is often forgotten in the rush to be as arrogant and as authoritative as some of your doctor colleagues.

Love, and all it implies, gentle kindness allowing for difference, might just be the new wave needed in the paradigm shift of care of the mad, those who need care, while we celebrate those who don’t, allow the mad community to walk with pride into the future free of fear, without the yoke of researched paid for profitable stigma.

As proud equal Irish citizens!

And how bad, how hard, how mad could that be?


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