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Constraints to mental health care in St Elizabeth

Published: Saturday | December 21, 2013 Comments 0

Launtia Cuff, Gleaner Writer

Out of a concern raised by Gregory Myers, councillor for the Southfield Division, to address psychiatric concerns of residents in St Elizabeth, Dr Doreth Garvey informed the council that there were many constraints to caring for the mentally ill and that health providers needed the support of relatives of the mentally ill as well as community members.

Garvey, who was addressing a council meeting, said the councillors themselves needed help to address these concerns.

Myers said he first raised the concern after visiting the Black River Hospital and seeing a number of mentally ill, persons on the compound.

"The concern for me was when I visited the Black River Hospital and going on the compound, you have several mentally ill patients on the compound. My main concern was that Black River does not have that facility for mentally ill patients," Myers told Rural Xpress.

Garvey said that in the '80s, the Government had proposed an integrated process towards managing the mentally ill, which would create a shift to community management so persons were no longer sent directly to a mental hospital. This was necessary, she said, as not only was there a lack of facilities to house all these patients, but persons trained in psychiatry were scarce.

"In this region, we have only two full-time psychiatrists and one part-time person. For St Elizabeth, I am the only psychiatrist who comes in, and I have a medical officer who assists me. We have mental health officers and there is one social worker who is assigned to the health department, not specifically to psychiatry.

"We have no psychologists working in the system and we have seven psychiatric aids that assist with the management of patients on the ward. Now, that means we may have one person per shift to manage, say, 15 males and five females. One person per shift is not enough to manage the female and male ward and emergency room. So there are challenges," Garvey told the council meeting.

She went on to say that although most of the mentally ill could be managed while remaining in the community, the hospital and health centre still played a vital role in their treatment. She said, however, they were sometimes faced with additional problems such as a shortage of medication.

Meet criteria

"The hospital does play a primary role, the health centres also because that's the first line that we want persons to come to - the health centre, where they can get their treatment and stay at home. If for some reason they're not settled, or there are some criteria they do not meet, we would admit them and stabilise them.

"We have had medication, but we've had problems maintaining the levels - the quantities - that we want, so the distribution is not consistent," the psychiatrist said.

She went on to say that often, crimes were committed by persons with undiagnosed mental-health issues. She added that such individuals had real medical issues and needed to receive help.

"We rely a lot on the police to assist if somebody is seen in the community and believed to be of unsound mind. The police can take the person to a facility where they can be assessed and treatment initiated if so needed.

"(If we) could prevent that person from going into custody, if they were to be taken to a facility where they should be treated, there would be fewer people in the jails in that regard. It is a programme which operates very well in other places and is called 'diversion at the point of arrest'," she said.

She added that those who needed to be removed from the community in order to receive treatment often had to stay in these facilities for extended periods as they often had nowhere to return to after they had completed their treatment. She said an option that could be explored was the development of a work programme in which they could be involved, which would put them on the road to being able to function on their own.

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