THE IRISH TIMES today (Saturday, May 21,
2005) in its Weekend Review has given prominence to
this story of John Manweiler who recently won a 3
million euro jury award for involuntary detainment in
a Dublin psychiatric facility and being misdiagnosed
as psychotic ("Vindication for a solitary man" by
Carl O'Brien, page 3). Best, Imelda, Cork
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"Vindication for a solitary man
John Manweiler was awarded almost €3 million by a
High Court jury after it found he was unlawfully
detained in a psychiatric hospital, and wrongly
prescribed anti-psychotic drugs for more than a
decade. He speaks for the first time about his
experience to Carl O'Brien, Social Affairs
Correspondent.
John Manweiler is quiet, withdrawn and almost
painfully shy. He speaks in barely audible tones. He
doesn't like socialising, dislikes crowded pubs and
hates trying to fit in. By his own admission he is a
loner.
"I'm not a sociable person," he says. "I've been like
that all my life. I used to get teased about it in
school . . . I don't have much to say to people.
They'd say: 'That's John there - has he no tongue in
his head?' Some people talk and talk and talk, have
the gift of the gab, make everyone laugh. That's not
me."
Manweiler (64) has led a solitary life. He is not
married, has drifted from job to job, and now lives on
his own in a local authority flat in Dundrum, Dublin.
Yet, looking back on his life, the loneliest he ever
felt was due to his treatment at the hands of the
psychiatric service.
Three weeks ago he was awarded almost €3 million by a
High Court jury which found he was unlawfully detained
in a psychiatric hospital and prescribed an
anti-psychotic drug for more than a decade because a
consultant threatened to lock him up in a secure unit
if he failed to take it. His case has raised questions
about the sometimes murky procedures used to detain
patients in psychiatric hospitals against their will,
as well as the attitude of sections of the medical
profession dealing with mental illness.
"You were told nothing," Manweiler says. "Nothing was
ever explained. I complied with what I was told to do.
It was either that or take a one-way ticket to another
country. I'm not the sort to do that. I'm very slow to
move."
The sequence of events which led to Manweiler's
involuntary detention in St Brendan's Hospital,
Grangegorman, from September until December 1984 began
when he overheard a conversation in the sitting room
of his parents' house in Blackrock. At the time he was
living at home and had been made redundant from a job
on the assembly line with the television company, Pye.
Standing at a partition between rooms, he says he
heard his mother and sister and a solicitor discussing
changes to his father's will. An earlier will had been
cancelled and a new one was to be drawn up leaving the
family house at Cross Avenue to his sister, Pauline.
He had been left out of the entire process, he told
the High Court.
"This really upset me. I felt very disappointed. She
was going to be the sole beneficiary . . ."
Around two years later, on September 20th, 1984, after
his father died, Manweiler was at home. His mother,
aged 83, was suffering from dementia. He had been
cleaning some rusting tools in paraffin earlier in the
day, but found they had been moved.
"I asked her if she had moved the tools and she said
no," he says. "I got a bit annoyed. When I found them,
I said she must have moved them. I threw the tools
into a flower bed. She was very surprised and said she
was afraid, that she would report me to one of the
family. I couldn't understand why she would be afraid.
I never threatened her, I never threatened anyone."
His sister Pauline and a brother, Colm, arrived at the
house later and, Manweiler says, told him he had to go
to St Brendan's psychiatric hospital. He told the High
Court that Pauline warned him that if he did not go
voluntarily, he would be "committed". He didn't want
to go, but felt he had little option.
He was signed in as a voluntary patient. The next day
he was told his clothes were being taken away and he
would have to wear pyjamas from now on.
When he was seen by a doctor, the notes at the time
recorded: "Chronic mild depression. Schizoid
personality. Short stay only. Then day care." This
note was to prove crucial in the High Court case 20
years later.
A schizoid personality is a disorder characterised
typically by traits such as emotional coldness, a
preference for solitary activities and a lack of close
friends. It is a personality disorder, not a mental
illness, and does not typically respond to
anti-psychotic drugs.
A week later the head psychiatrist, Dr Henry Burke,
concluded that Manweiler was mentally ill and changed
his status from a voluntary to an involuntary patient
under the Mental Treatment Act (1945).
Burke told the High Court that he did this partly on
the basis of evidence of a history of violence he
obtained from a nurse who was familiar with the
patient and the family. Manweiler spent the next three
months as an involuntary patient.
"All I remember is the boredom. We'd play draughts.
That's all I remember. And TV. We had no personal
belongings, no privacy . . . I just wanted to get out
of there," says Manweiler, recalling life on ward 3A.
"There were all sorts there. There was a man with a
stroke, there were some very elderly people. There
were some alcoholics as well."
During this three-month detention, he was interviewed
by a psychologist, who confirmed that he did not have
any psychosis. Despite this, Burke prescribed
Manweiler Clopixol, an anti-psychotic drug used to
alleviate symptoms often associated with manic
depression, such as paranoia and hallucinations. Burke
told the High Court he did this because of Manweiler's
"history of violence". Manweiler still remembers the
first injection.
"After an hour or so I didn't know what was coming
over me," he says. "I had no control over some of my
arm; my hand was moving around. I couldn't control my
hand."
Manweiler maintains that Burke told him that if he did
not have the injections, he would be detained in
locked secure unit 8A. Dr Burke vehemently denied this
in court.
After his discharge in December 1984, Manweiler
continued receiving treatment on an outpatient basis,
and was prescribed the anti-psychotic drug for the
next 11 years. He says he complained of the
side-effects of the drug and insisted he was not
mentally ill.
Burke retired in 1991. In October 1994 Manweiler was
told by another psychiatrist he was to be taken off
the drug. He then began to pick up the pieces of his
life. He was prompted by a sympathetic nurse to make
an official complaint about his treatment.
When the Freedom of Information Act was passed, he
finally got access to records he had been seeking for
years. He also spent time reading up on aspects of
mental illness.
"The more I read, the more I realised what had
happened," he says. "I'd spent a lot of time in
bookshops, reading up about schizoid personality. They
were probably wondering who is this character who
keeps coming in but doesn't buy any books."
When the jury in the case considered five key
questions relating to Manweiler's detention and
treatment, they found in his favour on each point. In
addition, the jury found that health authorities had
aggravated the injury to him by the manner in which
they conducted their defence of the action. Manweiler
was characteristically restrained when the ruling
came. There was no outburst, just relief at being
vindicated.
"I was confident. I'm not sure why. I wasn't elated,"
he says, in soft tones. "People say to me, look at all
the money. I never had any money in my life. I have
savings, I get the disability benefit. That's all I
need. . . What I can do now is try to put it all at
the back of my mind and begin to forget about it."
© The Irish Times
John Manweiler: 'The more I read, the more I realised
what had happened'.
Photograph : Alan Betson
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Today's front page story in THE IRISH TIMES "Status
of detained psychiatric patients to be reviewed" also
focuses on abuses in psychiatry. I have pasted this
in below.
----------------------
"Sat, May 21, 05
Status of detained psychiatric patients to be reviewed
[Carl O'Brien, Social Affairs Correspondent]
Up to 600 psychiatric patients who are detained
against their will in psychiatric hospitals are to
have the legal status of their detention reviewed by
independent experts. Carl O'Brien, Social Affairs
Correspondent, reports
All decisions by consultant psychiatrists to detain
involuntarily these patients will be reviewed by
mental health tribunals which are due to be
established shortly.
There is concern among campaigners and health
professionals at the relatively high detention rates
in psychiatric hospitals compared to other European
countries.
Regional differences in committal rates mean patients
are up to three times more likely to be detained
against their will, depending on the part of the State
where they live.
Details of the extent of the review of involuntarily
detained patients come just weeks after John Manweiler
(64) was awarded €3 million by a High Court jury which
found he was unlawfully detained in a psychiatric
hospital and improperly prescribed anti-psychotic
drugs for more than a decade.
Bríd Clarke, the chief executive of the Mental Health
Commission, the State watchdog for the mental health
sector, said plans to establish the tribunals were at
an advanced stage but were being delayed by a dispute
involving hospital consultants.
Former inspector of mental hospitals Dr Dermot Walsh
said yesterday he had issued a number of circulars to
consultants asking them to review the legal status of
detained patients but he was disappointed by the
response.
"I asked them to do it as a matter of civil rights and
also in view of the task the Mental Health Commission
would face when all these patients' have their cases
reviewed," he told The Irish Times. "The number who
still remain involuntarily is disappointing."
Latest figures show there were 23,234 admissions to
psychiatric hospitals in 2002. Ten per cent of all
admissions were involuntary.
Under the 1945 Mental Treatment Act, a person may be
detained in a psychiatric hospital for six months.
This can be extended for up to two years.
Under the provisions of the Mental Health Act 2001,
due to come into force shortly, each decision to
detain or extend the detention of a patient will be
subject to automatic review within 21 days by a mental
health tribunal.
The Mental Health Commission estimates that once these
measure come into force, up to 600 patients who have
been detained against their will for long periods of
time will have their cases reviewed. The commission
hopes these measures will be in place later this year.
It is almost certain that a significant number of
patients will have the status of their involuntary
detention lifted. For example, latest figures show
there are up to 170 patients with alcohol addiction
problems, but who do not have a mental illness,
detained against their will. This practice will end
under the new regime.
Meanwhile, legal sources say the implications of the
Manweiler case are significant for other psychiatric
patients who feel they were unlawfully detained or had
their rights breached.
The jury found in favour of Mr Manweiler on six key
points relating to his unlawful admission and the
prescribing of anti-psychotic drugs.
In a statement to The Irish Times, the Irish College
of Psychiatrists said that while it could not comment
on the case, there were complex reasons behind
variations in involuntary detention. These included
the absence of proper multi-disciplinary teams and
emergency duty social workers and the varying levels
of spending on mental health services between the
different health authority regions.
Dr Walsh said that new safeguards due to come into
force were aimed at ensuring there was not a repeat of
cases such as Mr Manweiler's.
"Had the mental health tribunals been in place in 1984
[when Mr Manweiler was detained]," Dr Walsh said, "his
case would have been automatically reviewed and all of
that would never have happened. Unfortunately these
safeguards are still not in place."
© The Irish Times