Left behind: Inside Bellevue’s ward for Jamaica’s forgotten patients

James Harvey*, 54, still moves as though he is standing behind a towering sound system.

Sometimes he rocks from side to side, blurting intros to dancehall hits as if the speakers are still thumping behind him. Nearby, Keith Dempson*, 62, straightens his posture and slips into a different performance.

“Attention please,” he announces in a crisp, practised tone – the voice of a man who once directed passengers through departure gates at the Norman Manley International Airport (NMIA).

Nearby, John Watson*, 65, watches over the room with quiet authority. A self-proclaimed don from Central Kingston in another life, he still makes it known that anyone around him is safe.

However the three men are not in a dancehall or an airport terminal.

For decades now, their world has been the hall-like ‘H’ Ward at Bellevue Hospital in Kingston — a rectangular building at the rear of the compound where bunk beds line the walls and days pass in steady routine.

They are among dozens of long-term residents who have spent years, sometimes decades, inside the institution. Many were discharged long ago but remain at Bellevue for a simple reason: there is nowhere else for them to go.

Some have not seen relatives in years.

Some say their families stopped coming altogether.

Across the hospital, there are nearly 400 such patients – classified as “social cases” – elderly men and women abandoned or forgotten by relatives who once brought them here.

For some, their mental breakdown was gradual, beginning in childhood. For others, it was triggered by traumatic life events. Regardless, their lives eventually intersected on the psychiatric wards of Bellevue Hospital.

Shared Space

For now, home for Harvey, Dempson, and Watson is H Ward. They share the space with others, singing, praying, and eating three meals daily after Watson, the longest-serving resident, guides the group through morning stretches.

Cared for by three female staff members, the men are bathed at least two times daily and fed from the hospital’s kitchen. Unlike residents on some other wards, they are physically active, yet their personalities and daily problems differ. Constant, however, is their sanitation, medication, and meals.

Walks in the hospital’s park, art, and games such as dominoes are favourites among them, said psychiatric nursing aide Lorraine Grant, who usually leads these activities. Grant has worked at Bellevue for two decades.

She fell in love with what has become her “dream job” after visiting the hospital where her mother worked for 37 years. She shared stories of murder and maiming that reportedly landed some long-term residents at the hospital, and said she has experienced almost every misdeed from patients – from uncooperation, to being slapped, to food being spat in her face.

Still, there is only one way she is leaving her beloved patients at Bellevue – and that is through retirement, she affirmed.

“This ward used to be the ward for the babies. When female patients had babies, this is the ward all the babies were on until they went to Father Ho Lung (Missionaries of the Poor),” she said, noting that pregnancies have significantly decreased over the years due to stricter segregation, tighter enforcement measures for patients, and stronger security to keep out hospital intruders.

“Coming here as a child and seeing some of what was going on at the time, I got to love the work. On top of that, after growing up and getting pregnant with a son with an intellectual disability, when it comes to these types of patients, I give 100 per cent just to take care of them. Because I wouldn’t want anybody to take advantage of my son,” she explained.

“Mark you, some of their relatives take them here and have never returned. We can’t send them on the street. So we have to take care of them,” she continued.

“Observation is the key to my work. If they are all out here, a staff member must be out here because they will run away without anybody realising. So we always have to be alert. I play with them, jump on them, bounce them. Because I love my patients – even the ones that don’t have any manners,” she said, smiling.

Longing for visits

Of the three, only Watson had received visits from relatives in recent months. Much like the others in H Ward, visits from loved ones are deeply yearned for; and in the midst of their mental illness, the thought of family brings despair to some of their eyes.

It shone most vividly in Dempson’s as his gaze switched from joy to darkness after informing the nurses – in his airport “intercom voice” – of departing and arrival times for their flights, how to store bags in the overhead compartment, and warning them not to smoke in the vicinity of the terminal building.

After 30 years institutionalised at various locations after “acting strange on the work”, his pain was palpable.

“My family them don’t come and visit me. They used to come and then them stop. They only phone that them a come, and then them don’t come,” he said, childlike.

“It kind of make me feel bad, and not so good in my brain. The nurse them say me not to fret over it, and them encourage me to go on and on, don’t follow family or anything. But sometimes it kinda come across me, and me don’t feel good. But them tell me that one day them going to turn up, so I can’t give up.”

Harvey, too, has relatives and a daughter who do not visit. Still, it bothers him that she is now a teenager and, the last he heard, “having boyfriends”.

Still the protector, Watson recalled how things have changed at Bellevue over the decades from a security standpoint – and that he is happy about it.

“People used to just rob pon di compound. Them used to rob and rape workers – gunman, you know. Workers and patients never safe. But from this guard company come in now it different for we. We alright now. Them things there can’t gwaan again. Them times there did disgusting,” he explained, his voice raspy and assertive as if ‘locking the ends’ back in the day.

Growing strain

Hospital CEO Suzette Buchanan explained that despite the care social cases receive from staff members, these elderly men and women are placing significant strain on the hospital’s $3.2-billion annual budget with food, clothing, and healthcare costs.

“It is often asked, ‘What Bellevue do with money?’ But we are the only place with 400 social cases, and it is an aged population that we have to take care of,” said Buchanan, who took over the reins of the hospital four years ago.

Food alone costs $20 million a month, while diagnostic tests add another $11 million.

“We don’t do diagnostics for screenings for cancer and other diseases, so we have to take them to private institutions each month and that racks up quite a big bill. The other day I got one for more than $1 million,” she said.

She added that public hospitals are often overcrowded and less accommodating to Bellevue patients.

“And I can’t afford for my patients to die from want and need – some of them have ovarian cancer, some have kidney disease, and so on.”

“These are people who are stable and have been discharged, but what a pandemonium it would create if I were to send out 400 of these patients onto the public. How would the public manage with them in addition to the ones already on the road?” she asked.

Buchanan said the hospital has seen a 17-per-cent increase in the number of Jamaicans turning up at Bellevue in the last three months following online public-sensitisation campaigns on mental health.

Some individuals are brought in by relatives, while others walk in themselves. Some even admit themselves around Christmas, knowing the hospital will provide safety and care – a stark contrast to life on the streets.

However with hundreds of social cases, there are no beds to accommodate new patients.

“The fact is, we need family members to come in and take them. Just like if they were admitted in other hospitals, it is your relatives who come in for you,” she said.

“It is practice that when you are leaving hospital… even when a woman goes to have a baby, you hear, ‘I’m going to pick up my wife’. So when it comes to mental health, it must be the same thing. We can’t just send them out there like that.”

She argued that the provision of halfway homes would be a better use of government funds than having such patients indefinitely housed at Bellevue.

In the United States and other jurisdictions, halfway homes are transitional living facilities designed to assist people moving from highly structured environments – such as prisons or inpatient treatment – into more independent, community-based living.

Inside H Ward, however, life continues in its quiet rhythm – meals, medication, stretches, domino games, and the occasional airport announcement echoing through the room.

corey.robinson@gleanerjm.com