Imagine spending nearly five years locked away in isolation, with nothing but four walls for company. This is the harrowing reality for Stephen Loughnane, a man whose family is speaking out about what they call an 'absolutely dreadful' ordeal, a situation that starkly contrasts with modern psychiatric care standards.
Stephen's journey began in Limerick Prison in 2021, a period of continuous seclusion that has since spanned across three different facilities: the old Central Mental Hospital (CMH) in Dundrum, Co. Dublin, and now the new CMH in Portrane, north County Dublin, where he currently resides. His mother, Jacinta Loughnane, explains that this prolonged isolation is due to a severe lack of suitable residential settings that can accommodate her son's complex needs.
But here's where it gets truly disturbing: Ms. Loughnane likens visiting her son to encountering a character from a horror film. "It's like going to visit Hannibal Lecter in the movie Silence of the Lambs — behind a screen with the glass and talking through a speaker," she shared with RTÉ Investigates. The rooms he has occupied are stark, devoid of any furniture or personal effects, leaving him with nothing but the bare walls. The thought of him enduring this 24 hours a day for nearly five years is, as she puts it, "heartbreaking" and "absolutely dreadful."
Recently, Stephen was moved to a larger isolation unit temporarily, a slight change after years in a smaller, unfurnished room. His story began tragically at the age of 16, when he was the sole survivor of a fatal road crash. This event left him with a brain injury that led to significant psychiatric challenges, including psychosis, hallucinations, and episodes of violence. Following an incident in 2021 where he attacked his mother, he was remanded to Limerick Prison, initiating his prolonged period of isolation before his transfers to Dundrum and Portrane.
Seclusion, a practice strictly regulated in mental health settings, is intended for individuals who pose a risk to themselves or others, preventing their exit from a room. At the CMH, this typically involves a stripped-down room measuring four by three metres, with limited access to an external cage. Communication with staff is managed via an intercom.
And this is the part most people miss: Stephen's detention in prison while awaiting hospital transfer highlights a significant flaw in the criminal justice system. While 23-hour seclusion is common in Irish jails, especially for mentally ill prisoners, prisons fall outside the Mental Health Commission's purview. Dr. Charles O’Mahony from the University of Galway School of Law points out that this situation raises "significant human rights issues" and exposes "significant gaps in terms of regulation and oversight."
While the HSE stated that the use of restrictive practices in Irish mental health centres has decreased to a record low following new human rights-based rules, this trend does not hold true for the CMH in Portrane. In fact, the use of seclusion or solitary confinement has been increasing at Portrane. In 2024, there were 82 seclusion incidents, up from 69 the previous year. The longest continuous seclusion episode recorded lasted an astonishing 20,880 hours, beginning when patients first moved into the new hospital on November 13, 2022. However, Stephen's uninterrupted seclusion began before his transfer to Portrane.
An inspection report identified seclusion policies at the new CMH as a "critical" risk factor, noting a "concerning upward trajectory of non-compliance" with regulatory standards. Stephen Loughnane's case is one of several featured in the RTÉ Investigates documentary, 'The Psychiatric Care Scandal'.
Here's another troubling revelation: Despite the new CMH having 50 beds available, including specialized units, more than three years after its opening, many remain unused. Meanwhile, a waiting list of 38 individuals are being held in prison landings, unable to access the same level of specialized anti-psychotic healthcare.
The controversy deepens when we look at community care: RTÉ Investigates also uncovered serious shortcomings in providing psychiatric care to high-risk individuals in the community. Consider the case of Leon Wright, often labelled "Ireland’s most dangerous prisoner." With over 120 convictions, including assaults on law enforcement and public members, Wright has been diagnosed with schizophrenia. He had shown improvement with medication and therapy.
However, after his release in 2019 with a care plan, the HSE's community mental health team refused to treat him due to the perceived risk he posed to staff. In October 2021, the Director of the Probation Service expressed his "completely unsatisfactory" view that access to community-based treatment was denied for two years, raising "grave concerns for Mr. Wright's ongoing welfare and... significant risks for himself, (probation staff) and the wider community."
Despite legal efforts, including unsuccessful High Court and Court of Appeal cases, community care was not provided. His solicitor explained that without medication, his symptoms worsened, leading to a violent confrontation with armed gardaí and his subsequent sentencing. He is now in isolation on the National Violence Reduction wing at Midlands Prison. His solicitor highlighted the paradox: "All of these supports were there except for the community and mental health care. The HSE are saying to him, basically, the only place where you're going to get mental health care is in the prison."
This raises a critical question: Is the system failing those most in need, pushing them back into the very environments that exacerbate their conditions? What are your thoughts on this complex issue?
