'Why is the mind treated differently to the body?' - Families devastated by murder-suicides call for change to law
Information on mental health is kept from patient’s family, writes Ralph Riegel
Una Butler's words were tragically prophetic. Five years ago, the young mother lost her beloved daughters, Zoe (6) and Ella (2), and her husband, John (43), in an horrific murder-suicide.
John had been suffering from depression and took his own life minutes after killing his adored little girls in their picturesque Ballycotton bungalow on Cork's east coast.
A heartbroken Una vowed to courageously campaign for a more open mental-health care system to ensure no other family endured her agony.
"Patient confidentiality is important, but we shouldn't put it on such a pedestal because it is important families are consulted and involved in treatment programmes," she said.
"They are involved in cases like cancer care so why not mental health?
"I believe it is all to do with the stigma over mental health cases.
"The reality in my case is that mental illness killed my children."
Under existing regulations, medical professionals are required to observe strict doctor-patient confidentiality, which means their hands are tied in terms of what information can be passed to families.
Last week, the inquest into a Charleville murder-suicide found that doctors had done everything they could to help the troubled young man involved in the killings.
In Una's case, her husband John had been receiving help for his mental health problems but she was not aware of just how severe his depression truly was.
Above all, Una now wants families formally engaged in mental-health care regimes so that they know precisely what is happening with a loved one.
If necessary, they would also be able to make special arrangements to minimise any risks until the individual is fully recovered.
Since 2000, there have been 30 murder-suicide cases in Ireland, and more than 40 children have been killed.
Cork alone has suffered three further horrific murder-suicides since those terrible events in Una's home in Ballycotton on November 16, 2010.
Two occurred in the space of just 16 weeks, in Cobh and Charleville last autumn.
Last Wednesday, devastated Charleville mother Helen O'Driscoll, pleaded for a change to medical confidentiality rules so that parents who have adult children living at home are fully aware of any mental health difficulties they are battling.
Helen's eldest son, Jonathan (21), launched a frenzied knife attack on his nine-year-old twin brothers, Patrick 'Paddy' and Thomas 'TomTom' at the family's Deerpark home in Charleville, Co Cork on September 4 last year.
Helen and her husband, Thomas, were away from home for the day purchasing a miniature caravan for the twins' impending birthday.
Each twin suffered more than 40 stab wounds in the unprovoked attack which occurred shortly after Jonathan had collected them from school.
Minutes after stabbing the twins, Jonathan drove to an isolated forest outside Buttevant, some 20km away, and took his own life.
He left five notes, three of which were found on his body and in his car, the contents of which Cork Coroner Dr Michael Kennedy described as "quite disturbed and quite disturbing".
It emerged during his inquest in Mallow last week that Jonathan, who had a history of mental health struggles since 2012, was suffering from depression, paranoia and psychosis.
One doctor, who only saw him weeks before the triple tragedy, was deeply concerned that Jonathan might he exhibiting the early signs of schizophrenia.
But the young man had stopped taking his prescribed medication days before the tragedy.
Helen was not aware of either the scale of his mental health problems or the nature of the medication he was on.
This was despite the fact her eldest son, who was fostered and then adopted, was living in the family's Deerpark home alongside his four younger brothers, Patrick, Thomas, Jimmy (5) and Martin (3).
"If adult children are staying with their parents, I think their parents have the right to know if they are suffering with some sort of a (mental health) problem," Helen said.
"At least the parents can be aware of that and they know to look out more clearly for what is going on."
Helen told the Irish Independent she was "totally shocked" by the number of medications her son Jonathan was on.
"I found a lot of tablets after Jonathan had passed away, God speed him. He seemed to be on a lot of tablets.
"But his inquest heard that it was reckoned he hadn't taken any medication at all for about a week before it happened."
What was truly shocking was that Helen's anguished plea for change is virtually a repeat of what Una has been campaigning for over the past four years. But despite Una's determined campaign, nothing has so far changed.
It has now emerged that Health Minister Leo Varadkar has a proposal before him, tabled by renowned Cork solicitor, Ernest Cantillon, who acts for Una Butler, for rules to be changed under the Mental Health Act.
This would mean that there is an agreed family involvement in patient treatment and arrangements.
"The law needs to be changed," Mr Cantillon pointed out.
"Here again we have another bereaved family member who believes that if they were involved in the treatment - or at least informed of the extent of the health concerns - a tragedy could have been avoided," he added.
Mr Cantillon said he has enormous sympathy for medical professions because they are caught by a requirement to enforce the confidentiality laws as they stand.
Despite the fact that October marks the fifth anniversary of her own tragedy, Una has still not even received the full Health Service Executive (HSE) report into her own husband's case and treatment.
Una will not comment on any case other than her own. "It is really frightening how frequently murder-suicides are now occurring in Ireland," she said.
"But the only time you hear anyone calling for something to be done about them is when the media are writing about them happening.
"There needs to be major studies undertaken and greater supports and funding for the mental health system.
"The welfare of children is paramount when living with someone suffering with their mental health and this should be taken into consideration by the medical professionals."
Una said her husband was left with absolutely no safety net, after his treatment for mental health problems.
Worse still, despite Ireland suffering from one of the highest rates of murder-suicide in the world, there has been little or no resources provided for major studies into the causes and possible prevention measures. Una says Ireland still labours under the stigma attached to mental health issues.
"People just don't want to talk about it," she said. "Why is the mind treated differently to the body? It is the stigma.
"People are ashamed. It shouldn't be like that," she added.
"The number of politicians I wrote to and never even got a reply. Why don't people want to listen?"
But the brave woman draws strength and determination for her campaign from the memory of her daughters.
"Zoe and Ella are with me all the time. I am living their lives for them now. Their spirits are with me all the time."