In 1977 a number of considerations prompted a review of the facilities for the mentally ill of ‘no fixed abode’ in St Brendan's Hospital, Dublin. At that time the hospital had three clinical teams who serviced three geographically distinct catchment areas within the city and attended to the needs of patients with ‘no fixed abode’ on a rotational basis. There were complaints from community care agencies concerned with the care of the homeless which alleged that patients were discharged without adequate preparation or follow-up. However, this view was not shared by hospital staff, who instanced occasions when patients sought help in what seemed to be a psychiatric or social emergency, and then abused the service by discharging themselves shortly afterwards. The truth perhaps lay somewhere in between. Another complaint was that no single medical practitioner was clearly responsible for these disadvantaged individuals, thereby making it difficult for community care agencies to liaise with the hospital staff.
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