Only one child psychiatrist in public health system
Last week’s revelation by the country’s senior medical health official that only one paediatric psychiatrist was working in the public health system jolted legislators and deepened fears that a suspected link between children reared in unstable families and Jamaica’s high crime rate would strengthen.
According to Dr Earl Wright, the health ministry’s director of mental health service and substance abuse, there are currently three paediatric psychiatrists in training. In addition, he said that there were vacancies for eight child mental health doctors, several occupational or activity therapists as well as a number of psychiatric aides to deliver out-patient care.
“It is not cool to have children as a single mother without the necessary support system,” Dr Wright told a Parliamentary oversight committee on human resources and social development.
He argued that the absence of fathers from homes caused psychological disorders among children, which sometimes manifested itself in the propensity of youths to commit crime. This phenomenon, he noted, was highlighted in the book entitled Born fe Dead, authored by Laurie Gunst.
Wright also revealed that there was a shortage of mental health personnel, noting that only about half of the 81 mental health officers required were in place.
He told the Parliamentarians that due to the failure of the family and other social institutions, the Jamaican personality, during the formative years, missed critical skills, including empathy, goal setting, recognition/management of feeling and the ability to compromise or negotiate. Hence, Wright noted, the high propensity to settle disputes violently.
He said that generally there was “a high incidence of personality disorder and psychosis in Jamaica” reflecting the universal phenomenon of schizophrenia being found among one per cent of Jamaica’s population. Of this number, Wright reported that public health facilities treated 10,000, with the balance falling to the privately-operated health system.
He said, additionally, that nearly a quarter of the population or approximately 650,000 persons suffered from some degree of mental disorder.
In light of Wright’s disclosure, legislators on Wednesday bristled at the proposed closure of the Bellevue Hospital, the island’s single mental health institution which is located in Kingtson.
“Are we going in the right direction? Are resources adequate (and) have we improved over the years?” asked Opposition member Mike Henry.
His colleague, Ken Baugh, a medical doctor and former health minister, noted that no special physical facilities for mental health care, except Cornwall Regional Hospital in Montego Bay, existed outside of Bellevue. Baugh suggested that the institution could remain in operation alongside an expansion of community-based health care.
But Wright, responding to these concerns, emphasised that the proposed closure of the 140-year-old Bellevue Mental Hospital would be done on a phased basis and was dictated by modern health practices that pointed to community-based care as the best approach to mental disease or schizophrenia.
“The patients will not be discharged from Bellevue until the appropriate services for each patient (are in place),” he explained.
When pressed by legislators about the precise nature of the patient service, Wright said there were proposals for the provision of four small “discrete psychiatric units” in the Corporate Area, at the St Ann’s Bay Public, Mandeville Public and Cornwall Regional hospitals. He added that these proposals were subject to the approval of the relevant regional health authorities.
In defence of the decision to phase out Bellevue, Wright argued that too much focus was being placed on the one per cent of schizoprenics in the society to the detriment of the larger proportion of mentally ill persons.
“The focus of Jamaica’s health care has been on the one per cent schizophrenics, exclusive of the 23 to 24 per cent of the population who are mentally unhealthy,” he lamented.
Wright, on prodding from committee chairman Dr Donald Rhodd, revealed that the $5-million budget for promotion needed an additional $10 million in order to educate members of the public about mental health. Rhodd said the committee, in its report to Parliament, would recommend additional resources for the country’s mental health care programme.
Meanwhile, Pearnel Charles, Opposition member of parliament for South Eastern Clarendon, said that he did not feel the presence of mental health officers in rural areas and urged the senior health official to rectify the matter.
Charles’ view contrasted with that of Patrick Harris, a medical doctor, and representative for Northern Trelawny, who acknowledged the presence of mental health officers in the field.