Mental health failings persist
(CNS): More than three years after the complaints office exposed the government’s failure to meet the requirements of its own law in regard the treatment of mental health patients, some of them are still being housed in jail when they present a danger to themselves or others. Following up on the ministry’s substantial failure to follow the recommendations of the office, made in 2009, Commissioner Nicola Williams has made public a special report detailing those failures and highlighting the serious legal problems that the Cayman government could face regarding its treatment of the mentally ill.
The most recent Special Report follows up on an Own Motion Investigation published by the pervious commissioner, DrJohn Epp, in September 2009. The issue in question remained the problem of where those who present a danger to themselves and others because of their mental health condition were housed. Epp found that people suffering from mental health problems were being jailed at Fairbanks on an ad hoc basis instead of being house in what could be described as a safe place. Following his investigation, Epp recommended that a place of safety was properly defined and designated to comply with the Mental Health Law.
However, some three years later, nothing of substance has been done and according to Williams, despite the office’s continued monitoring and extensive correspondence with the health ministry’s chief officer and others, the problem has not been addressed. Mental health patients in Cayman are still being jailed even though they have not committed any crime.
Williams pointed to a number of problems that such a situation presents, from the failure of the authorities to address the needs of the patients to the human rights implications of the government failing to comply with the law and subsequent recommendations of the OCC. Despite some 30 months of correspondence and the establishment of a Mental Health Task Force in 2010 which drew up a draft change to the law, nothing has been done to address the problem of incarcerating the mentally ill.
The issue has been highlighted by numerous experts over the years and has featured as the subject of key reports
In 2009 the late William Rattray, who served as the commissioner of corrections, pointed out that prisons are not mental health hospitals.
“The prison officers, while trained in interpersonal skills and physical restraint, if necessary, are not mental health nurses. Consequently, it is my view that is not adequate as a place of safety for mental health patients who have not been committed to prison as an untried prisoner, waiting for sentence or sentenced to imprisonment by a court,” he told Epp during his original report. “Imprisoning someone on the grounds that they have a mental health problem but have committed no offence is a violation of their human rights,” Rattray added.
The chief medical officer at the time had also pointed out that the ad hoc approach to mental health patients in danger and the use of Fairbanks was in appropriate. Epp’s report threw up a number of major issues, not least the violation of the rights of the mentally ill and their false imprisonment. But the fact that Fairbanks appeared to be the only place where patients could be accommodated was not, the OCC found, a lawful excuse.
However, despite the seriousness of the problem, efforts to address it appear to have failed and Williams was forced to issue the Special Report as a result of the ministry’s non-compliance.
“Special Reports are only prepared and issued by this office where there is serious and protracted non-compliance,” Williams said Wednesday. “As evidence of the seriousness of this matter, the OCC is required by law to provide the Governor with a copy of the Special Report before it is laid before the Legislative Assembly. This was done on 5 April 2012. The decision to issue a Special Report, provide a copy of same to the Governor, and lay it before the Legislative Assembly is not one that is taken lightly. This is the first Special Report I have had cause to issue since my appointment as Commissioner,” she added.
In the report, the health ministry's chief officer, Jennifer Ahearn, denied that the ministry had made no progress on the issue and stated that the task force had been “working diligently and continuously”.
In her last correspondence with the OCC in April of this year, the chief officer said that the task force continued on with the draft legislation and the need to designate a “place of safety” but made it clear that with the legislative department’s workload and the now imposed financial constraints on government further delays were to be expected.
CNS has contacted the ministry and is awaiting a response.
OCC Special Report 24 April 2012 – Re: Mental Health and Place of Safety tabled 22 Oct 2009
Category: Health
Once again we see the "Alice in Wonderland" approach to reality by the Cayman islands. My God, what exactly makes you people imagine yourselves to be so extraordinary? You have mentally ill people within your society. You always have done. We are all in the same boat. Deal with it.
And the Minister tells us that Government can't afford a facility and hopes the private sector will build one yet they have millions to waste on Hurricane Hilton!! Shows you who really needs help. Whay not use that facility as a place to provide help to people who really need it instead of pandering with another handout where one is not needed.
I must agree 100% with 20:57 below, the mental health coverage in the private health polciies is a disgrace in the 21st century. I remember when our business got a new insurer and the woman came in to tell us how great the policy was, but simply mentioned as an aside stated that there was no cover at all for mental illness. It sounded barbaric and Victorian. If there is something wrong with one's liver it is covered, if there is a problem in the brain it isn't.
A friend had a breakdown and was in and out of hospital, checking herself out in the middle of the night. When I asked how she was allowed to do something like that, especially being a risk to herself and others, I was told there is no mental health facility here. Mental illness comes in all shapes and and sizes just like people, a treatment/safehousing facility is definitely a priority.
Someone with a mental illness enjoys the same rights and freedoms as anyone with another type of illness. That is, they can refuse treatment and sign themselves out of the hospital at any time. UNLESS, they are in fact deemed to be a threat to themselves or others, in which case they can be involuntarily hospitalized under the Mental Health Act, on the Mental Health Ward.
Mental illness does not exist in the Cayman Islands.
The current position with repesct to the terrible coverage offered by local health insurance providers for mental health issues must also be addressed. It is criminal that such a very real illness can be carved out of health insurance policies, the treatments are incredibly expensive and can financially devasate families – families that already have tragic circumstances to cope with.
Unfortunately any form of mental illness is not a priority for Cayman instead it is something to be ignored and hidden away if possible! Shame on us for not pushing our Government to deal with this very real illness.
prison is full of mentally I'll people who don't get the correct treatment or environment they should be given, housed on cell blocks with others they can cause havoc because of their behavioural problems etc, its a disgrace, no one cares, simple as, staff are expected to manage theses inmates without any mental health training and also issue medication until they don't respond and have to be taken physically to the nurse for an injection, FACT
Why don't you just tell us if there is any government department that isn't grossly failing to do what it's meant to do despite being aware of the issues for years and having a huge staff and an annual budget some full-sized countries would be proud to have? I know why….because it would be a very short news article.
Putting someone with a genuine medical problem in jail, especially in this day and age is absolutely scandalous. If the NBF was genuinely for nation building, the first item on the list it should be spent on is a dedicated mental health ward/hospital to care for these people, rather than simply handing it out carte blanche to churches and others selected by you-know-who.
Miss Williams has now released TWO (2) damning reports on 2 different Ministries and Chief Officers. In the private sector, a report of this crucial imporatnce would cause the respective persons responsible to be fired. Mr. Deputy Governor, we have FAITH in you- so please now REMOVE the 2 women Chief Officers and replace them with CAPABLE, RESPONSIBLE, EFFECTIVE and TRUE leaders. These 2 reports in as many months certainly leaves alot to be desired. With management of the porportions, is there any wonder or reason why the Civil Service is a mockery. Accountability needs to satrt taking place and now is the perfect time for it to happen. If any help is needed serving the seperation letters, I will volunteer to get the job done!!!!
But such reports are treated with utter disrepect by Caymanian polticians, who simply make an immediate knee kerk response that the report is wrong and they are right and nothing changes.
Everyone says it's real nice at Northward. What's the problem?
" …so now REMOVE the two women chief officers and replace them with CAPABLE, RESPONSIBLE, EFFECTIVE and TRUE leaders". Yes, Deputy Governor, at least one genius on CNS has given you advice. So if you take it, you add these two ladies to Dr Astley McLaughlin, Deborah Drummond, and Diane Montoya in sitting home collecting salaries. but never fear, the genius has said to you "I will get the job done".
I wonder why the fact that they were "two women" was specified in this post.