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Marchan’s killing highlights mental health stigma

Published: 
Sunday, March 19, 2017
Police officers during a recent exercise in Port-of-Spain. Their actions are being called into question following the killing of Paul Marchan, a mentally ill man.

The killing of mental patient Paul Marchan by police officers is not only unfortunate in itself, but may also have the effect of increasing the stigma against mental illness.

Marchan, 30, was shot dead by officers from the Western Division Task Force last Thursday evening. The police were called in by relatives after Marchan began hurling objects at their house. The police actually came twice—once at noon, when they were unable to locate Marchan, and then again at 5 pm, when he doused himself with a flammable liquid and locked himself in a car.

The same relatives pleaded with the officers to break the car windows and get him out before he set himself on fire and, when the officers got a door open, Marchan reportedly wounded two of them with a broken bottle and a razor blade. It was then that the situation escalated, leading to Marchan being shot four times.

Mr Marchan’s relatives are claiming that police acted hastily, given that they had been informed that he was mentally ill. But the exact circumstances are not yet known and it is a fact that two officers sustained wounds before resorting to their firearms. According to family members, Marchan was an outpatient of the St Ann’s Hospital and had bipolar disorder.

This is a condition in which individuals experience extreme emotional states, going from depressive to manic in cycles. The disease is usually controlled by drugs, but sufferers have to make sure to take their medication regularly. If they fail to do so, their symptoms return with a vengeance. But, even so, most bipolar persons do not become violent.

Unfortunately, in T&T, the mentally ill suffer from a stigma, in part because the most visible victims often live on the streets in urban centres such as Port-of-Spain and San Fernando. Officially, there are over 3,000 persons in T&T who have a clinical mental disease, but the actual number is probably much higher since, because of the same stigma, most persons are unlikely to get treatment.

Indeed, in cases where they are taken to St Ann’s, it is often because their families are simply unable to cope. Persons who may have milder symptoms or who are able to function fairly well may remain undiagnosed and untreated. Two-thirds of mental patients are male; nearly half of patients are between 40 and 60 years old, while one-third are in the 20-39 age bracket.

Given Mr Marchan’s erratic behaviour, citizens may wonder why he wasn’t safely incarcerated. But, as a general principle, mental health professionals prefer that patients live with their families, because this is better overall for their mental state. And, since most mentally ill persons are not violent, being out in the wider community poses no danger in normal circumstances. But, for this strategy to work, patients who rely on medication must take their pills and should avoid as far as possible the stressors that might make their symptoms manifest.

Needless to say, this cannot happen without support from family, friends and other social networks. And lapses will occur. In extreme situations like the one last Thursday, police officers too often prove unable to handle the disturbed individuals and, apparently, mental health workers aren’t available after 4 pm.

So, at the very least, there are some training and bureaucracy defects that need to be fixed in order to fashion a better response when persons with mental disease need to be restrained.

Officially, there are over 3,000 persons in T&T who have a clinical mental disease