Several high-profile investigations are expected to be finalised this week by the Office of the Director of Public Prosecutions (DPP).
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315 new inmates at St Ann’s
Constant humiliation and belief in demon possession are delaying effective treatment of mental illness. Walt Murphy, president of the Association of Mental Health Officers of T&T said, “This thing about demons has informed and has delayed from development of appropriate treatment methods.” In a Sunday Guardian interview, Murphy said it took centuries for people to realise there was a cause for mental illness. Though he said progress has been made, people still call the mentally ill, ‘chupidee’ or ‘madman’ regularly. He said history has also stymied proper treatment.
“Words convey stigma,” he said. Murphy said, even some medical practitioners do not accept mental illness as a disease, just like diabetes. He said the stigma runs so deep that a family member’s first line of response is that their loved one is demon possessed. Murphy said many of them hold steadfastly to Biblical stories of Jesus Christ casting out demons, although the family member may be ill.
Another response has been that the mentally ill person is just “playing the fool.” Because of stigma people blame the illness on some other cause. However, by the time they return for treatment, the illness has already worsened. In the public health care system 40,000 to 45,000 people have been seeking mental care but the figure is much larger as many people visit private practitioners.
Religion does, however, have therapeutic effects, but Murphy said a number of religious leaders sometimes make unsavoury statements. He said they may tell the person they’ve become mentally ill because they have broken God’s laws. “There are people who have done everything right but they have been pre-disposed to the factors,” he said. In contrast, some people have been spared simply because they have not been exposed to significant stressors.
You could be next
Be forewarned: It could happen to you. At any moment mental illness can affect anyone regardless of status, race or job title. Murphy, as well as secretary of the Association of Psychiatrists of T&T, Dr Varma Deyalsingh, divulged this information. “There are persons who made sport of the mentally ill, and later on, they themselves...” Murphy trailed off.
He said there was a myth that lack of proper parenting causes mental illness. However, Murphy listed three major factors. He said there was a genetic factor, which is still being debated, the familial factor (hereditary) and organic factors, such as brain injury. Though T&T’s society stigmatises and even quivers in fear at some mentally ill people, fast-paced living has caused a rise in anxiety disorders.
To compound matters, there have been 315 new in-house patients at the St Ann’s Hospital for over the last 11 months. Dr Deyalsingh said stress, such as unemployment has contributed to these mental health problems. In the past, Deyalsingh said, there were many schizophrenic and bipolar cases at the hospital. However, he said, that has been changing.
“They have been seeing a lot of depression cases, substance abuse, comorbid conditions,” he said. Comorbidity in the case of substance abuse is where the user becomes psychotic. “First time admissions have now shown a trend that depressive illness, and substance abuse, comorbid conditions, are responsible for the new admissions.”
He said most of the new patients are referred to Ward One—the model ward on the St Ann’s compound often referred to as “The Hyatt.” “Admissions average about ten new cases per month.” He said from January to November, there were 146 new female cases and 169 new male cases.
Not all patients are violent
Deyalsingh said if people were sufficiently educated about mental illness they would tend to be less discriminating. “We tend to see people who are outside and violent and that gets us scared, and that is only in the minority. “Thinking that all mentally ill patients are violent needs to come out of people’s minds,” he said.
Deyalsingh said the majority of mentally ill people want to withdraw into themselves. He said though there are more mentally ill people outside of the St Ann’s Hospital, that was not necessarily negative. “We want to integrate people back into society,” he said. However, he said there was normally an outcry from communities when recovering mentally ill patients are re-integrated in their area.
The St Ann’s Hospital houses 1,042 patients but he said, “Far and large, people mentally ill may not have to reach an institution.” Of that number, the majority are schizophrenic and bipolar disorder cases. The growing mental health issue is not just at St Ann’s and, Deyalsingh said, at the Community Health and Wellness Centre in Barataria, there are at least five to six new cases per month. At the Centre the population is roughly 3,000 whom they see every three months.
Poor conditions at mental institution
The United Nations General Assembly, 17 December 1991, Principle 13, outlines the ‘Rights and Conditions in Mental Health Facilities’. It reads in part two: “The environment and living conditions in mental health facilities shall be as close as possible to those of the normal life of persons of similar age and in particular shall include:
(a) Facilities for recreational and leisure activities. A worker for more than four years at the hospital, who sought anonymity, stated that patients were without a physical education room for months. When the Sunday Guardian visited, the room was locked and other workers in the Occupational Therapy Department (OTD) next door said it had not been completed.
The OTD building was missing galvanise sheets from the roof and window panes were broken. The Sunday Guardian noticed that St Ann’s was plagued by leaking and dilapidated buildings. Plant life could be seen growing from different buildings and paint was constantly flaking off one of the walls on Ward 14. It was said that if not watched carefully, one of the young adolescent patients would eat the paint. Though the patients were being cared for, workers complained about the environment. Water was also dripping from the roof of the hall and green moss grew there.
There is no known cure for mental illness but people can be made well enough to function on a daily basis.However, in all disease conditions, there are persons who will get better on their own. Such persons have to maintain a low stress lifestyle.
major triggers of mental illness
• Illegal drugs & alcohol
• Nutritional deficiencies
• Age related conditions, eg, Alzheimers
• Stressors such as bereavement, sexual abuse and domestic violence.
There was also a gaping hole in the hall’s wooden flooring, which was blocked off by a make-shift wooden box. Workers told the Sunday Guardian that was where patients were accommodated for functions. Commenting on the St Ann’s facility, Deyalsingh said, “We are lacking in that sense. We need to make the institutions more comfortable. It is regrettable, not just for the patients but for the caretakers.”
However, he said there were many workers who have remained at the institution to help. Health Minister Therese Baptiste-Cornelis said she recently put together a new Mental Health Committee. She said she was seeking to remove mental health responsibility from the North West Regional Health Authority—the only RHA to have responsibility for mental illness.
The Minister said that way she would be able to get direct oversight for St Ann’s. She said St Ann’s was sometimes treated as the step-child. “People treat it like it’s something you can avoid but, it’s like diabetes,” she said. She said sometimes families refuse to accept they’re depressed. Regarding St Ann’s infrastructural conditions she said, in time, all that will be looked at.
Average age of onset for mental illness:
Generally between 17 and 25
Generally between 16 and 28
However, this is not set in stone as age brings challenges and also, there have been cases of schizophrenia in children.