Mental illness requires adequate management


Tuesday, May 21, 2019

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Last Sunday, it was reported that a woman and her grandson had been chopped to death by her mentally ill son in Trelawny. This is yet another warning that we fail to take the problem of mental illness in our country seriously to our peril.

Sometime in the 1840s, an area for the treatment of the mentally ill was constructed adjoining Kingston Public Hospital. In 1861, the Jamaica Lunatic Asylum was built at 16 1/2 Windward Road, Kingston. In 1946, the name was changed to Bellevue Hospital.

In February 2016 the auditor general revealed that Bellevue had 795 patients and 85 per cent, or 673, were considered stable based on their clinical assessments. Although these 673 patients could be discharged, they remained at the facility because of family neglect and other social issues. The auditor general recommended that the Ministry of Health should immediately explore the benefits associated with the implementation of the mental health reform plan, including the relocation of patients from Bellevue Hospital to community-based living facilities. This is in line with the thinking of most mental health practitioners in developed countries.

The son of someone I know has mental health issues. They live in a country that has a fully developed plan for handling the care of the mentally ill. An apartment is made available to him by the Government, along with financial assistance. He is monitored closely by mental health workers to ensure that he sticks to the treatment plan set out for him.

But that's where the problem starts for us. We do not have the resources to provide this kind of community care. The 673 people mentioned by the auditor general, who should be leaving Bellevue but remain because they are not wanted or cannot be cared for, should send a powerful message that this fancy system cannot work here. Let's look at some of the reasons:

* There is the feeling among many Jamaicans that mental illness is the work of demons.

* Others think it is punishment from God.

* Family members are not trained to care for a mentally ill person, do not understand the condition, and are just downright scared of the manifestations.

* There is a stigma that is attached to the patient, family and friends that has negative implications for employment and relationships.

So, inspite of these glaring facts, an inappropriate, understaffed, underfunded agency is set up and these people are let loose on society — no plans for accommodation, no training of caregivers, no treatment plan. Well, let me tell you what happens: Trigger -happy cops use them for target practice, and family and community members beat, stone and curse them; they are also blamed for assorted crimes and thrown into the cesspits we call correctional facilities to languish and suffer. And they suffer.

Before we condemn family members, let me share part of a letter that was written on April 28.

“...Who is responsible for caring for mad people. For 15 years my mad sister is ruining my life. She is unemployable in her nursing field. She has known of her bipolar disorder for 10 years. Every three years she has to be bailed out of homelessness and is dead broke. She has sponged off of every family member until I have to rescue her again. She lies, steals, has delusions/hallucinations, and cannot live with someone without rearranging the entire house 'better' and decides what you want and don't want...”

A senior person from the mental health community was on the news Sunday night stating that the mentally ill individuals must remember to take their medication. But may I respond as respectfully as I can by saying, “Bull manure, Sir!”

Yes, again, that's what the manuals say. But which seriously mentally ill person is going to be walking around with their “treatment plan” diary? And, even if they do, did it dawn on anyone in the mental health community that there may be a reason why they do not repeat their medication. Well I have. And I have observed. The main reason is because of the terrifying side effects of the drugs offered to them. The effects of some of the hallucinations are chilling to watch. Which person in his right 'mind' would repeat. Has anyone thought of trying different, more suitable medications? The 'one size fits all' is not working. Trust me.

My heart goes out to the many family members who have absolutely no idea what is happening to their loved ones and are not getting the appropriate help. To them, permit me to say this, people with mental illnesses who are receiving effective treatment are no more violent than anyone else in the community. People with schizophrenia are more likely to harm themselves than harm others. Prompt and ongoing treatment and support are the key to reducing violence among people with a mental illness.

When you are faced with violent and aggressive behaviour, avoid confrontation until the person calms down and becomes reasonable again. Speak firmly. A firm “Stop it now” sometimes helps the person to regain control. Then it is a good idea to have a plan of who you are going to call for help if things get out of control.

If and when the opportunity arises, you could ask one of these mental health experts the following questions:

* Are mentally ill people responsible for their actions when they are not mentally aware of the impact they are having on the real world?

* Do we blame epileptics for their seizures, or diabetics for their comas? If not, why are we treating individuals with other illnesses this way?

To the caregivers and family members, I suggest that you all put away the cutlasses and other defensive weapons. Arm yourselves with knowledge and you may be surprised how soon the loved one you knew returns.

Glenn Tucker, MBA, is an educator and a sociologist. Send comments to the Observer or

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