ST JOSEPH’S INTELLECTUAL DISABILITY SERVICES

Stephen McGrath, Director of Public Information, Northern Area Health Board describes the developments which are underway to ensure that no persons with an intellectual disability will be cared for in a mainstream psychiatric hospital setting by 2006.

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A specific service to meet the needs of persons with an intellectual disability is managed by the Northern Area Health Board (NAHB) and based at St Ita’s Hospital, Portrane, in north County Dublin. This is called the St Joseph’s Intellectual Disability Services. Services are provided both directly by the NAHB and on behalf of the health board by a number of voluntary agencies through a range of community and residential settings.

An enormous amount of work carried out by dedicated and committed staff goes into the welfare of intellectually disabled patients being cared for at St Ita’s Hospital, Portrane and throughout north Dublin.

The evolutionary process in dealing with clients on the campus of St Ita’s has seen considerable development in residential, community and campus-based facilities. Currently a total of 243 people with an intellectual disability live on the campus of St Ita’s Hospital, down from 400 in 1993. These persons are accommodated on the St Ita’s campus in ten hospital units with a total of 175 patients, ten group homes accommodating a total of 68 residents. There are a further 71 residents accommodated in a variety of community settings in north Dublin.

Tremendous advances have taken place in this service in recent years. Ambitious plans are in place to achieve further improvements for the intellectually disabled in the geographic area served by the NAHB, which provides health and social services to people of Dublin city and county north of the River Liffey. During the last few years more than 200 patients have been relocated from the St Ita’s campus to community settings.

These include group homes, a modern supported living complex in Stillorgan with 30 places and a purpose-built complex with 30 residential places and day facilities at Clonmethan, Oldtown, Co. Dublin.

In addition customised facilities in the form of individual houses are being purpose built on the St Ita’s campus for a further 60 clients to meet the very complex needs of persons presenting with challenging behaviour.

The model developed by the Northern Area Health Board is designed to meet the complex needs of persons with severe and profound intellectual disability, accompanied by challenging behaviour. In tandem with supported accommodation developments on the campus of St Ita’s, the Board plans to purchase individual houses in the community and thereby provide an extended range of choices for clients.

The following developments in the care of the intellectually disabled have been put in place in recent years:

  • Psychiatric services and services for the intellectually disabled on the campus at St Ita’s have had their own separate and distinct consultant-led dedicated services since 1988.
  • In keeping with the government’s health strategy Quality and fairness the NAHB is determined to ensure that no persons with an intellectual disability will be cared for in a mainstream psychiatric hospital setting by 2006.
  • In addition to residential care the St Joseph’s Service provides 140 day-care placement for the intellectually disabled.
  • The total number of respite bed nights, for clients from the community, provided for 2001 was 1666.
  • A full range of recreational facilities is provided for clients of the service, including our own extensive modern holiday home in Co. Wexford.
  • The NAHB was the first in the country to establish a School of Nursing in Intellectual Disability.

Beginning in the 1980s, the St Joseph’s Intellectual Disability Services developed a wide range of community services for the intellectually disabled including day and residential. The aim has been to replace services provided within St Ita’s Hospital with community-based facilities including supported living complexes.

People with an intellectual disability have complex needs and it is not always possible for these complex needs to be met in a conventional house in the community. For almost 15 years now the St Joseph’s Service has been involved in developing purpose-built community-based facilities designed to meet the needs of our residents. These began under the direction of the former Eastern Health Board with the development of:

  • The Good Counsel Centre in Ballyboden.
  • The supported living complex in Maynooth.
  • Clonmethan Complex at Oldtown.
  • Hawthorns supported living complex in Stillorgan.
  • Nine community houses in north Dublin and a further five attached to the Good Counsel Centre, Ballyboden (now called Southside Intellectual Disability Services).
  • Partnership arrangements with transfer of clients to voluntary providers in line with client need and in consultation with families and carers.

Two further customised community-style complexes are in the final stages of the planning process for the St Ita’s campus. Similar customised accommodation is planned for Lusk and the North Circular Road, Dublin. The Board also intends to continue its policy of purchasing houses in the community and adapting them to meet our clients’ specific needs–other houses will be purpose-built in strategic locations. The supported living complex at Clonmethan, Oldtown is now fully occupied and will be officially opened shortly.

The process of physically relocating intellectually disabled patients from St Ita’s Hospital into the community could not have happened overnight. The process must be done on a phased basis and the Board is on target to achieve this by 2006. The Board has the full support of the Eastern Regional Health Authority and the Department of Health and Children in this process. From the Board’s perspective the reorganisation/redevelopment of the Intellectual Disability Service at St Ita’s is a complex process, particularly because of the challenging nature of the client population and their particular needs. For this reason it has to be pursued in a measured and systematic way. Furthermore the strategic location of new facilities is very important as indeed is the capacity of the Board to recruit and deploy staff to these facilities.

The St Joseph’s Intellectual Disability Service also operates a community support team, based in the heart of the community in the Castle Shopping Centre in Swords, which is easily accessible to clients. This team operates Monday to Friday, providing home support, outreach and assessment services.

Day placements on the campus of St Ita’s are facilitated through 20 individualised day activity centres which provide 130 full-time places. A further ten places are provided at Lusk in north county Dublin. A number of our clients avail of the services provided by the Eastern Vocational Education Group in Maryfield, Swords; Prosper Fingal also provides places.

St Joseph’s also provides and facilitates a full range of recreational activities for our clients. Clients who live and work in the community are supported in fully integrating their skills and ambitions with that of the local community. Clients on campus have the full use of a recreational therapist, our holiday home in Wexford and numerous organised outings and activities during the year.

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