The sad, disgraceful treatment of persons afflicted by mental illness continues as prisons are used as dumping grounds for psychotic individuals and funding for appropriate, community-based services falls short.

Political and official promises of increased investment have disintegrated when confronted by demands grounded in high-profile health failures and trolley-based hospital crises. A plan to move the Victorian-style Central Mental Hospital in Dundrum to St Ita’s in Portrane is due to happen by 2020. With a planned capacity of 170 beds, however, it is not expected to meet anticipated demand.

In the meantime, prisoners who are deluded and hallucinating have to sleep on the floor of a dedicated wing at Cloverhill Prison because there is no room to accommodate them at the Central Mental Hospital.

When it comes to providing services for disadvantaged people, citizens with mental health issues are invariably shuffled to the back of the queue

All available beds are occupied there even as a refurbished ward lies empty because of a shortage of nurses. Some 30 prisoners remain on a transfer waiting list at Cloverhill. Requests to recruit psychiatric nurses at both centres have not been sanctioned by the Health Service Executive.

When it comes to providing services for disadvantaged people, citizens with mental health issues are invariably shuffled to the back of the queue. Large mental hospitals, closed in the 1960s, were to have been replaced by community-based services. That did not happen. The number of beds fell from 12,000 to 1,000.

The number of people with major mental health problems coming before the courts has been increasing, according to professionals in the Courts Service because of drug abuse, homelessness and other factors. In some instances, the offences are relatively minor but those involved can be psychotic and delusional.

Inadequate psychiatric help for children and young persons is seen as contributing to this situation. Early intervention at community level represents a necessary first step. But long-term planning for institutional care is also urgently required.