Fri | Mar 23, 2018

Bellevue clear-out - More than 500 persons abandoned at mental health hospital could be relocated

Published:Sunday | February 19, 2017 | 12:00 AMErica Virtue
Dr Myo Kyaw Oo (left) chats with Minister of Health Dr Christopher Tufton (centre) and Dr Winston De La Haye, chief medical officer, during a tour of a section of the Bellevue Hospital last December.
The entrance to the Bellevue Hospital, where officials have indicated they do not have the space to house a mentally ill man who is threatening to kill his mother.

The Mental Health and Homelessness Task Force established by Health Minister Dr Christopher Tufton has recommended the construction of a new facility to house the hundreds of persons who have been discharged from the Bellevue Hospital but who remain at the mental health facility.

According to the task force, there are 549 persons with mental illness who have been discharged from Bellevue but who have remained there because of challenges reintegrating them into their communities.

These persons are putting a serious strain on the hospital's purse as it costs some $117,000 each month to feed and care for each patient.

The task force has recommen-ded several options to the government to address this problem but the one it most favours is for the creation of a new adult care facility on the hospital lands, but which would not be a part of the hospital.


Advantages to approach


"This approach has a number of advantages. The physical facilities are already in place so additional costs to build a new facility would not be incurred. The adult care facility would not be part of Bellevue Hospital and, therefore, not incur the high costs associated with a hospital," said the task force in its recommendations to Tufton.

"The CEO and management team of Bellevue Hospital are already responsible for the physical facility and the persons living there. They could set up a simple management and staffing structure for the adult care facility, which would continue to be served by the canteen and other facilities at Bellevue Hospital.

"Staff currently working at Bellevue Hospital could be offered the option of working within the adult care facility instead of within the hospital," added the task force.

It argued that the adult care facility would remain within the ambit of the Ministry of Health, at least initially while it becomes a separate entity that is not part of Bellevue Hospital.

"The management team at Bellevue has already identified what would be involved in establishing the adult care facility as a separate entity with its own utility meters and entrance. Certain services such as food could be provided by the Bellevue Hospital on a contractual basis," said the task force.

According to the task force, after 12-24 months, this could be reassessed and a decision made if the facility would be turned over to the local government ministry or be converted into a private-public partnership.

"There are a number of public-private partnerships in Jamaica with respect to the mentally ill and the elderly. However, there is no obvious partner currently available. Steps would need to be taken to consult and seek a suitable partner," the task force noted.

Other options recommended to Tufton include maintaining the present status quo, which has already been rejected by the auditor general as unworkable, or adopt a programme for the accelerated reintegration of discharged persons into their communities.

Late last week, Tufton told The Sunday Gleaner that he did not have a preference for any of the options as he is yet to discuss the recommendations with the stakeholders.

"Bellevue has become an institution that represents permanency for a number of the inmates at the institution for a number of reasons. In the traditional approach to treating patients, institutionalisation was a key component, and over time those persons have adjusted to feeling like that is home," said Tufton.

According to the health minister, in some instances, releasing the patients had adversely affected them, while others were abandoned because families and those factors contributed to their long-term stay at Bellevue.

Tufton noted that the new thrust worldwide is for less institutionalisation and more community-based treatment and therapy for the mentally ill, except in cases where individuals are violent and are threats to themselves and others.


Options for dealing with long-stay patients at Bellevue



Option 1


Status quo


Option 2


Maintain current status with accelerated reintegration of discharged patients into the community.


Option 3


Build a new adult care facility on the Ken Royes lands.


Option 4


Transition the wards at Bellevue Hospital housing the discharged long-stay persons into an adult care facility.


Option 5


Establish an adult care facility managed by the Ministry of Local Government through the Board of Supervision.


Option 6


Establish an adult care facility managed by an NGO or private organisation or some form of public-private partnership.