Physical and mental health of vulnerable groups must be protected

In this issue of the Medical Independent, we have published a feature on Covid-19 in Irish prisons. Speaking to this newspaper, Dr John Devlin, Clinical Director at the Irish Prison Service (IPS), said the Service has been “reasonably successful” in terms of controlling Covid to date. As of late July, there had been 11 outbreaks in Irish prisons.

As is made clear in the feature, Covid-19 does not just threaten the physical health of people in prisons. A recent report from the Irish Penal Reform Trust (IPRT), Irish Prisons and Covid-19: One Year On, highlighted how isolation and loneliness during the pandemic had severely impacted the mental health and wellbeing of this population. During outbreaks, a mental health protocol is implemented, including using iPads to communicate with people who are at risk; manned telephones for psychological first aid; and care packages with activities for those in isolation.

It is hoped, as with society at large, the vaccination programme will herald better days ahead. At the end of July, over 5,195 vaccines had been administered to prisoners, with a number of prisons completing the first and second doses of an mRNA vaccine. The prison population is but one of the vulnerable groups impacted by the pandemic. Of these, Travellers remain the highest at-risk cohort. Over a 14-month period, there were 5,226 Covid-19 notifications among Travellers. At 169 per 1,000, this represented three times the rate among the general population (50 per 1,000). Also, 4.5 per cent of Travellers were hospitalised, compared to 0.5 per cent of the general population.

Recently, the HSE National Social Inclusion Office and the Department of Housing, Local Government and Heritage published The Report on the National Traveller Covid-19 Accommodation Preparedness Checklist. The report outlined the actions and outcomes of a collaborative initiative to strengthen Covid-19 preparedness and infection prevention and control in Traveller accommodation.

Also, like the prison population, the mental health of the Traveller community has been deeply affected by the pandemic. In an opening statement to the Oireachtas mental health sub-committee on 13 July, Pavee Point’s Ms Geraldine McDonnell said Covid-19 “came at a time when our mental health was already at a crisis point”. Travellers have a six times higher suicide rate than the general population, and it accounts for about 11 per cent of all Traveller deaths.

The IPRT and Pavee Point have been calling for the publication of national reports into prisoner and Traveller health, respectively. The health needs assessment for Irish prisons has been delayed to ensure the report reflects the “current situation” of Covid-19 in prisons, according to the IPS. The report, due to be finalised in June, is currently being completed and will go to the Department of Health, Department of Justice and IPS for consideration.

And a national Traveller health action plan, the consultations for which took place in 2018, is still being reviewed by the Department of Health. It is of utmost importance these documents are published as soon as possible to point the way forward for the healthcare requirements of these two groups during the pandemic and beyond.