IT looks like a regular family house in a residential area.

White concrete garden seats beneath a canopy of fruit trees in the front yard, a driveway leading to a grilled foyer. The building has been renovated. You can tell by the updated architecture boasting French windows, fresh grille work and modern paint colours.

But the occupants are anything but regular. They are a hodgepodge of mentally ill men and women, older folk and young people whose families fork out $50,000 each month for qualified professionals to take care of them. The money covers room and board, meals, some medication, and nursing care.

This is Eden Brook, a privately run organisation that offers residential care to the mentally ill. Located in Vineyard Town in the capital Kingston, Eden Brook is one of six such facilities reportedly operated by a well-known corporate area doctor under the umbrella of Community Group Homes Limited.

There are similar facilities in the Corporate Area which are not run by his entity, like the one on Osbourne Road, near Cross Roads, called New Creation Nursing Home.

Viewed from outside, you might think it a prison, what with coils of razor wire runnning along the top of a super-high concrete perimeter fence and intimidating metal gates painted black.

It’s safer for the clients that way, the staff insists.

Under the guise of searching for private nursing care for a fictional mentally ill relative, the Sunday Observer sought to find out what the facilities of these private institutions were, and whether or not they were regulated. Employees allowed us to tour bedrooms, bathrooms, recreational areas and main living spaces.

Inside the gates of New Creation, residents are scattered about, some sitting on chairs in the yard, some lying on mattresses on a porch. Others are watching TV sets in the sitting area and under a huge shed in the yard used for taking meals and recreation.

There are about 45 of them in total, mostly suffering from schizophrenia, a nurse said. Three or four of them share a room; females and the elderly (both male and female) occupy the main building, while younger males are assigned to the other. We were only given partial access to the male quarters and so could not determine the conditions there. In the main building, however, there are four bedrooms and two bathrooms. Each room has bunk and single beds, chests of drawers, but no closets.

There, $50,000 covers nursing care, accommodation and meals. Medication, doctor’s visits, travelling expenses and toiletries are billed separately.

“Not much occupational therapy is done here,” the nurse admitted. “But they have a netball court, tennis tables, a small library. Sometimes we have classes for them but because their interests change so often and because some of them have (Attention Deficit Disorder), it doesn’t make much sense.”

If relatives require that their loved ones get therapy, they have to arrange it privately.

At Eden Brook, which has a capacity of 24, the set-up is similar: three or four persons share a room. But the furnishings are sparse and several pieces in less than desirable conditions. There are single beds but no chest of drawers or closets, only lockers. There are three bathrooms, one of which is for females only.

The living room walls are decorated with pictures of the clients on a recent outing, as well as artwork they created themselves. It’s part of their occupational therapy, a nurse said. So, too, are the chores they perform on a daily basis, from doing the dishes and cleaning the dining tables, to watering the plants and doing laundry, she said.

When we contacted the Ministry of Health, Director of Mental Health Services Dr Maureen Irons Morgan maintained there was a place for such facilities, especially in light of government’s policy to gradually move away from institutionalisation to community mental health care.

Section (4) of the Mental Health Act (1999) allows for privately run group homes, which it calls mental nursing homes.

“We will look at different provisions that can be made for the mentally ill in the community because that is the policy: to move towards community care, which is more humane and more in keeping with the needs of the people,” Irons Morgan said.

Without using the terms group homes or private residential care, the mental health director said it is anticipated that similar facilities will multiply in coming years.

“The community mental health policy has been the strategic plan we’ve been working with since the 1960s; it’s not anything new but I anticipate that, yes, as we progress more provisions will be made at the community level.”

Dr Irons Morgan, however, declined to say definitively if the existing homes were registered with the ministry, but suggested that some of them were not up to standard.

She also didn’t say how many of them were in existence, but, according to a January 2011 study by rights activist Yvonne McCalla Sobers, who has a close relative with a mental disorder, there are seven in the Corporate Area.

“Yes, we know about them,” Irons Morgan said.

Asked if they were registered with the ministry, she said: “I’m not going to answer that.”

“What I can say is we’ve been having a number of meetings with them and inviting non-governmental organisations involved in mental health care — and even nursing homes, too, because we do have mentally-ill patients in nursing homes — to kind of update people as to what the requirements and standards are,” she said.

Operator of New Creation, Hopeton Williams, said his facility — which was set up at least seven years ago according to the number of years a particular client has been residing there — was registered with the ministry. The Sunday Observer did see framed certificates hanging from the wall in his office, but they were illegible given the height.

The study authored by McCalla Sobers was born out of a quest to find suitable residential care for her relative. She visited four of the seven homes she identified, rating them according to standards used in the United States. In the end, she decided to keep her loved one at home.

She found that, except for one case, there were more than the recommended eight individuals cohabiting in the group homes and that the nurse/resident ratio of 1:6 or 7 was not adhered to.

She gave all four homes failing grades in their attempt to recreate a home environment, frowning in particular on the “padlocked grilles” and “high wall topped with razor wire” at some of them.

The facilities also failed, according to McCalla Sobers, to provide “privacy and access to quiet areas”, meaningful occupational therapy which would impact the amount of time spent “wandering aimlessly” and “staring into space”, and in ensuring that the staff was adequately qualified and continuously trained.

She concluded: “The group homes in this study met the most basic of the needs of the mentally ill: food, shelter, and medication.

There was, however, no evident attempt at rehabilitating residents: no life skills, individualised therapy, occupational therapy or structured opportunities for creative self-expression.

“The operation of the homes seemed based on warehousing the mentally ill rather than attempting to help them recover and function with some measure of independence.”

Attempts to get comments from the operator of the Eden Brooke facility were futile up to last evening as staff at the UHWI said the doctor was off the island and he has not so far responded to a Sunday Observer e-mail.