Sick tending to the Sick- substandard mental healthcare in Jamaican

Stephen Fray

I was pleased to see more coverage on the deplorable state of our mental health care services in Jamaica in the Sunday Observer. Its about time. For the past three weeks I posted several topics covering the inhumane treatment of persons with mental illnesses in Jamaica. The articles looked at  the state of private homes for the mentally ill and general lack of  statutory bodies ensuring that we meet basic international standards for care.

Dr. Sewell, a Psychiatrist working at the University Hospital of the West Indies in the Psychiatric Unit admitted there is little consideration of basic human rights for the mentally ill in Jamaica. In fact our lack of standards is in direct contravention of those set by the International Covenant on Economic, Social and Cultural Rights, of which Jamaica is a signatory country.

Dr. Sewell also bemoaned the shameful fact that we do not have a forensic mental health unit or hospital in Jamaica contrary to other Caribbean Islands that have already implemented such facilities. He went on to used the case of Stephen Fray as an  example of Jamaica’s constricted and maladaptive forensic misdeeds.

In 2009 a Jamaican named Stephen Fray attempted to hijack a Canadian Airliner, that was about to take off from Montego Bay, Jamaica . He was diagnosed after his capture with Schizophrenia but sentenced nevertheless to 83 years in prison.  There were also reports that Mr. Fray may have also had a pre-morbid diagnosis of Traumatic Brain Injury. Fray’s sentence was handed down by the courts in record time! not once was placement in a mental health facility given as an option despite his diagnosis. Well, where would we put him and what treatment would he get? We have no such forensic facility in Jamaica!

What is it like for the mentally ill in a Jamaican prison? Dr. Sewell contributed to another  article on the outrageous and sick conditions of persons diagnosed with a mental illness in the prisons . In it he reported that the mentally ill are treated worse than the other prisoners. Jamaican prisons themselves are already in direct contravention of human rights and the conditions are way below acceptable standards. However, incarcerated persons with mental illness suffer in an environment not suitable for even vermin. Rehabilitation is out of the question.

Wait, there is more absurdity! When contacted about this atrocity the Deputy Commissioner of Custodial Services at the Department of Correctional Services (DCS) in Jamaica , Gile Campbell, pleaded ignorance. If that isn’t grounds for immediate replacement for someone more awake and aware I don’t know what is.

The brave Dr. Sewell’s assertions are true, even though in my opinion, they are sanitized. When I visited and assessed persons diagnosed with Schizophrenia in prisons and country lockups I saw their blatant mistreatment for myself- they were kept in dank dark and unbearably small cells with many other inmates; they did not have access to their medication, some were not adequately clothed and many were underfed. Why? we can only point to stigma and the belief that mentally ill persons do not deserve to be treated as humans.

This belief is rife in our society across all boundaries. A team of mental health professionals, myself included, conducted a study on the stigma of mental illness in Jamaica called Mad Sick Head Nuh Good.  Published in the Journal of Transcultural Psychiatry in 2010, we found wide scale stigma attached to mental illness in Jamaica and a general feeling that those with mental illnesses are dangerous and should be avoided. We also found out that Jamaicans differentiate between “normal” people, “mentally ill” persons and those who are just plain “MAD”.

Question is, with all this data to show our shortcomings, where is the movement to at least live up to our human rights agreement? Is our society as mentally ill as those we are supposed to help?

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