Many children suffering from mental disorders are falling through the cracks due to a lack of education and resources, according to Mental Health Commission chairman and psychiatrist Dr. Marc Lockhart.
“As dire and severe as things are for adults on island, it’s doubly worse for children,” said Dr. Lockhart.
The Cayman Islands Health Services Authority treated 366 children between the ages of 4 and 17 for a mental illness in 2012, but the true figures, said Dr. Lockhart, are more like 600 when taking into account children seeking medical treatment in the private sector.
Childhood mental health issues are also putting a strain on the public school system, as teachers are unable to cope with children’s behavioral issues, said Michael Myles, coordinator of the At-Risk Youth Program.
“I think it’s a major issue. It’s an issue that we haven’t paid a lot of attention to that’s now becoming a major challenge to a number of our youngsters that are impeding on our education.
“I am dealing with it every single day,” said Mr. Myles.
“When it comes to mental health issues, our school counselors aren’t equipped to deal with that. Our school counselors are outnumbered. The [mental health] students need therapists and psychologists; they don’t need a school counselor to speak to them for 15 minutes,” he added.
Dr. Lockhart said the incident last week where a woman with mental health issues allegedly smashed up two downtown George Town eateries with a machete was an example of a patient with a chronic mental illness – a condition that often initially shows up in childhood.
“It’s a big problem, and it’s the root of the other mental health problems we see in adults,” said Dr. Lockhart. “The reason is, the majority of mental disorders, especially the chronic type, are disorders of childhood.”
He said about 50 percent of all chronic psychiatric disorders manifest by age 14. “That means the adult person wasn’t diagnosed as a child,” he said.
“Unfortunately, because we don’t have enough resources to be proactive about these disorders, we generally don’t get a clear understanding of the illness until its much later on, when they are in their 20s or 30s or 40s.” Minister of Education Tara Rivers acknowledged that mental health issues are prevalent in the public school system.
“There is a need to ensure that we strengthen the mental health provisions for the country as a whole, but in particular for our young people who are struggling with these issues and still expected to perform at school,” the minister said. Mr. Myles said there is often a stigma attached to mental illness which can lead to kids being left untreated.
“We lack education. A major part of this is that we have too many parents that don’t understand, so they don’t seek help or they prolong or delay support. By the time a child gets into their teenage years, it’s become so stigmatized that they don’t want to get help,” said Mr. Myles. Ms. Rivers agreed, saying, “As a country, it has been a long time coming, but for whatever reason we have not wanted to talk about it. Mental illness is the third most prevalent chronic disease in this country behind heart disease and diabetes. ”
No inpatient facility for children
Currently, there is no mental health facility designated for children, which results in many children having to share facilities with adults, or travel overseas to receive hospital treatment.
“We complain about just having an eight-bed unit for adults, but there is no unit for children,” said Dr. Lockhart. “Currently in Cayman, when we have children with severe mental health issues that require hospitalization, the only place that we have to put them is in an adult unit, which creates significant logistics issues.
“We have to get extra staff to keep adults away from children. Usually what happens is we end up sending these children overseas, which increases costs for all of us and separates families.”
Ms. Rivers said she has been lobbying for the establishment of a mental health facility.
“I’ve given that commitment to help move us forward towards getting a proper mental health facility on island to help deal with students that are sufficiently affected by this,” said Ms. Rivers. She added, “Some of our young people need that extra support and intervention. A lot of the problems manifest themselves in schools, but they don’t start in the schools, so … having that holistic approach to dealing with our young people is so very vital,” she added.
The recently formed Mental Health Commission is exploring existing buildings to use as a facility, Dr. Lockhart said, but this could take up to 24 months, as opposed to building a new facility, which would take much longer.
“For so long we’ve been focused on trying to build brand new facilities. As time has gone on, we realize that things are becoming more serious, and from a financial standpoint our focus is trying to look at options of existing buildings or facilities that we can somehow adjust and expand on to it,” he said.
He added that there would be no need to bring in trained specialists from overseas to the new facility.
“The expertise is here on island. We’re not talking about something that we have to bring in trained specialists from abroad. We have the adequate expertise, and we have the ability at University College of the Cayman Islands to train our nurses. It’s really more about identifying a location,” he said.
Dr. Lockhart said there are five psychiatrists working on island, as well as child psychologists, plus two or three Caymanian students are currently abroad, pursuing degrees in psychology, he said.