Surviving despite the odds - Jamaica's lone mental-health institution going the extra mile

Susan Callum, Gleaner Intern

Delroy Greysits on a bench at the Bellevue Hospital staring into the unknown. He stares with an intensity of purpose as if he were carefully observing the workings of the world inside his head. Delroy suffers from schizophrenia, and today, the mentally ill 34-year-old, whose ragged and dishevelled clothes are hanging on his frail frame, is being abandoned by a frustrated relative.

Beverley Grey describes herself as a caring and devoted stepmother who has looked after Delroy since he was a little boy.

She said, however, that she can no longer keep him at home because he has become violent again. "Just wha day him run down some a di children dem which part we live fi harm dem. Mi caan deal wid him 'cause him waan beat everybody. Him no take him medication fi months now and him smell bad cause a three weeks now him nuh bathe," Beverley said.

She has been wrestling with staff at Bellevue Hospital for half an hour, trying her best to have her son recommitted to the psychiatric facility.

Accommodation problem

However, the hospital says it cannot take him in because there is no bed for him there at the moment.

Bellevue Hospital has been criticised in the past for being inefficient and Beverley said she has now joined the ranks of those critical of the psychiatric hospital because of its "slackness".

But Shelly Thompson, a former employee of Bellevue Hospital, believes that it does a decent job with the limited resources it has, and places the blame directly at the feet of management, saying a lack of visionary leadership and financing are preventing the hospital from running at its best.

"Bellevue is the sole psychiatric hospital in Jamaica and mental patients from all over the island who need to be committed are sent there. So there is a big problem with accommodation at Bellevue, especially as the facility also acts as a housing facility for many homeless elderly persons. Staff members at Bellevue do wonders with the limited resources that they have to cater to the entire country," Thompson said.

"Employing more staff, doing structural building repairs, purchasing equipment, and purchasing updated psychiatric drugs are what visionary leadership and financing could improve," Thompson said.

Psychiatric aide Keisha Thomas agreed: "We would like to purchase some new equipment around the hospital and fix up a lot of the buildings around here with more money. But mostly, Bellevue needs more workers to attend to the patients here."

According to Thomas, patients outnumber psychiatric aides at Bellevue, and this creates a problem for personal and proper patient care.

"On this ward, there are only two psychiatric aides to about 100 patients, and we have to keep the patients clean and safe, make sure they don't harm themselves and each other. I have even seen patients fighting and because the psychiatric aide staff is so little, we cannot break up fights in time. So we need more workers," she added.

Financial constraints

Social worker Annette Francis said Bellevue, like the rest of Jamaica, is in need of more social workers. Currently, there are six social workers at Bellevue to cater to the 800 patients at the psychiatric facility.

In the budget for this fiscal year the Government allocated just over $1billion to Bellevue, but Chief Executive Officer Claudette Lewis said that does not provide it with much room in which to operate.

"I wouldn't say there is much flexibility in the budget the Government provides. We are given a budget, and with that we have to house, feed, clothe, and provide heath care to all our patients. The money that the Government supplies us does not cover building repairs, and so we have to get other funding for that," Lewis said.

Despite the issues with securing funding in this economy, Bellevue Hospital continues to provide a comprehensive rehabilitative programme geared towards re-introducing patients into their communities once they have done their stay at the facility.

This complete rehabilitative programme was introduced to Bellevue Hospital in 1974.

The hospital also has flexible visiting hours for family members and encourages them to work alongside staff to make patients feel loved and valued.

Names changed upon request.

Susan Callum submitted this piece as a part of her research work while reading for her degree at CARIMAC, University of the West Indies, Mona.

•  Some gains made but still a far way to go

The treatment of the mentally ill in Jamaica was again placed under the microscope last week as the nation joined the rest of the world in marking Mental Health Week.

While noting the theme 'Mental Health and Chronic Physical Illness: The Need for Continued and Integrated Care', local officials expressed a level of satisfaction on the achievements.

Consultant psychiatrist Dr Aggrey Irons said Jamaica has a very advanced mental-health system which stands up to scrutiny anywhere in the world with modern mental health service and supporting laws.

It was a similar story from Health Minister Rudyard Spencer who pointed to the thrust towards community-based treatment of the mentally ill.

But just how much is being done to assist the most vulnerable persons with mental-health problems, particularly those who seek assistance from the public-health system or those in prisons?

Can Jamaicans really be satisfied with the measures implemented so far?