• Dr. Paul D'Alton

Interview: Mental health should be sixth vital sign in hospitals

Mental health should be sixth vital sign in hospitals, says Dr Paul D'Alton.


Dr Paul D'Alton and Marian Finucane outside St.Vincent's University Hospital, Dublin.
Dr Paul D'Alton and Marian Finucane.

Clinical psychologist Dr Paul D’Alton would like to see mental health added as a sixth vital sign in hospitals and health centres across Ireland. Currently, those signs are pulse, blood pressure, weight, temperature and respiratory rate but D’Alton believes that patients will recover faster if their mental health is acknowledged as part of their overall illness.


“People’s psychological health has a huge impact on how compliant they are with their in-patient and out-patient treatment. Also, it impacts on the length of time they stay in hospital. Younger patients come into acute care setting expecting that their emotional health will be acknowledged,” says Dr D’Alton who heads the psychology department at St Vincent’s University Hospital, Dublin.


While communications between doctors and patients have arguably improved in the last 20 years or so, D’Alton says that patients’ behaviour can often be misunderstood in busy clinics. “Some patients’ [negative] response to treatment might be rooted in their early experience and if the medical staff understands this, they can respond more compassionately to the patient,” he says. “Distress is normal when faced with a serious illness but those who are upset, afraid and lonely for more than two to three weeks need more help,” he says.


St Vincent’s University Hospital, Dublin has one of the largest teams of clinical psychologists working in an acute hospital in Ireland. Psychologists work with patients with chronic pain, cancer, dementia, cardiac and neurological conditions. With other health professionals, they run free courses in chronic disease self management, mindfulness-based cognitive therapy and coping with cancer-related fatigue. They also train other healthcare professionals how to best ask patients personal questions related to their illness while helping the healthcare professionals themselves cope when patients die on their watch.


“We’ve done a lot of work to help staff cope psychologically when working with terminally ill patients. Death can be seen as a failure in an acute hospital and staff feel like they let someone down but death is the most natural thing. It’s important to know that sometimes, as a staff member, you won’t know what to say to a terminally ill patient or that you might become fearful of the death of one of your loved ones.”


This interview with Sylvia Thompson was originally published in The Irish Times 28/05/18.