“People will die. And I would include myself in that.”
 
Those are the alarming and brutally honest words of Rory Stokes, former frontman of Dublin punks The Sussed. They are words said with no trace of drama or self-indulgence. Instead, his tone is weary, realistic.
Following a horrific incident in which he witnessed another man burn himself to death back in the 1990s, Rory was diagnosed with post-traumatic stress disorder. Since then he has been receiving ongoing treatment for that and related conditions.
Rory is one of many whose lives will be immeasurably damaged by changes in the HSE Drugs Payment Scheme, which were confirmed last week.
This story has been in the air for two years now. When Hot Press last spoke to Rory in 2009, he faced an uncertain future. The then-Minister for Health Mary Harney was pressing ahead with plans to cancel the free psychiatric drugs scheme that Rory and others in the Eastern Health Board area have been availing of for over 12 years. A subsequent public outcry, allied to extensive media coverage, led to the proposed changes being cancelled at the time. Now, however, with another set of government cutbacks looming, it appears that these cuts will be re-activated under the supervision of current Minister for Health, James Reilly.
Drugs prescribed to mental health patients will no longer be free. Instead, effective from November 1, people in the greater north Dublin area attending outpatient mental health services who do not hold a medical card must pay the first €120 per month for their medicine, with only costs above that amount being subsidised.
It’s a major blow to Rory and to others who are in a similar position. However, the manner of its implementation makes him even more frustrated and upset. Rory stumbled upon the information by chance at his clinic last month, having spotted an HSE-branded notice pinned to the wall, detailing the planned changes.
“There was no publicity in the papers, no nothing,” he says, the anger clear in his voice. “The bottom of the flyer reads, ‘Thank you for your co-operation in this matter’, signed by nobody. Nobody has taken responsibility for doing this. It’s 100% cowardly and they’re hitting the most vulnerable people.”
It’s not only patients who have been left in the dark. Hot Press contacted a number of pharmacies and found that they too had been given little or no prior information, most merely receiving the notice in the post.
“Our members are acutely aware that this is a very, very vulnerable group and some people will find the changes difficult to cope with,” says Gerard Howlin of the Irish Pharmacy Union. “Our main concern is that our pharmacists will be as helpful and sensitive as possible in what is undoubtedly going to be a difficult situation.”

For Rory, unemployed since May of this year and reliant on four different kinds of psychiatric drugs, including anti-depressants, anxiety medication and sleeping tablets, he must quickly figure out a way to find stability, with only social welfare payments as income.
“Should I pay for rent, should I pay for food, or should I pay for my meds?” he ponders. “Obviously the meds are going to have to come third. I’m on €188 a week. I don’t get rent allowance and I don’t have a medical card because my girlfriend works. It’s been suggested that she would be better off quitting her job and going on the dole so that we can both get a medical card and rent allowance.”
The irony is that in financial terms, they probably would be considerably better off. It’s the classic welfare trap, into which people are being pushed by the State. Meanwhile Rory is convinced that there is an imminent risk to lives arising directly from the decision.
“People will die because of this,” he states. “Definitely. It’s extremely hard to withdraw. The medication I’m on is the new generation of SSRIs and you’re supposed to wean off them over six to eight months. People are going to stop taking them overnight. Do I not take half my dosage to save money and tell the chemist I only need half? It’s extremely addictive stuff.”
A self-described “functioning depressive”, the loss of his job through redundancy didn’t help matters.
 “I hate daytime TV, sitting at home, and being bored out of my mind. You need to keep your mind active. Everything builds up and you start worrying about worrying, and you end up bottling it up,” he reflects.
Perversely, these cuts come at a time when those affected by mental health issues are being encouraged to stand up and seek help.
“The stigma is still there,” Rory maintains. “It’s been that way since I’ve been growing up, since I was a teenager, and it seems not to have changed. It’s like the church thing, it’s been swept under the carpet for so long. When the Hot Press article came out in 2009, a few people in work that I hadn’t been friends with came up to me and said, ‘Jesus you’re so brave’. But other people who were talking to me on a regular basis just suddenly stopped.”
The move has been strongly criticised by John Saunders, director of mental illness support centre Shine.
 “People who are affected need to check if they are eligible for a medical card and if so, that they’re covered for this,” says John. “Those who aren’t eligible and are of limited means need to explain this very clearly to the HSE, that they’re in a very difficult and dangerous situation.
“The HSE have to respond to people like that,” he adds, “and they have to look at a system that allows them to continue to get their medication free of charge or at a really low cost and not just impose a guillotine on November 1.” 
Right now, the mental health system appears to be failing those in need.
“I think the funding of it is a failure,” Rory concludes. “The people who actually work in it are brilliant. I have nothing but praise for them.”
Sadly, it’s not praise that they need right now. It’s the funds to help those that are in imminent danger.
Over to you Minister Reilly.