Prison attempting to address mental health care gap

There is currently no clinical psychologist on staff at the prison, contributing to delays in providing court-ordered assessments and reports for defendants with mental health issues. 

The prison service is attempting to fill the gap by using experts from private practices and the Health Services Authority. 

But high demand and a general lack of resources for mental health patients in the Cayman Islands is contributing to a backlog of cases. 

Prison officials acknowledge there is an urgent need to fill the post, which has been vacant since December 2014. 

Raquel Solomon, spokeswoman for the prison, said the recruitment process was taking longer than expected, partially because of a lack of qualified applicants locally. “The qualifications and experience are such that we only received three applications, none were Caymanian and only one candidate was actually qualified. We now have to cast our net wider and recruit internationally to fill this post,” she said. 

Ms. Solomon said the prison was attempting to bring someone in part time to fill the gap in the interim.  

The prison’s clinical psychologist is responsible for assessments requested by probation services or the courts and oversees the mental health needs of the prison population. 

Ms. Solomon said it was difficult to cover the workload while the recruitment process continues. 

“Mental health services are at a premium. The doctors that do this work in the private sector and with the Health Services Authority are in extremely high demand,” she said. 

The issue is having an impact on the courts.  

Fiona Robertson, a lawyer with Samson & McGrath, said the inability to get court-ordered mental health assessments done at Northward prison was resulting in sentencing delays for some clients. 

“There is a chronic need for more doctors on the island that can do these types of reports,” she said. “The problem we have is that the speed at which the reports can be provided is not quick enough, and in some cases sentencing has to be delayed.” 

Mental health assessments are not required in every case, though they are frequently requested by probation services and can be ordered by the court prior to sentencing. 

“It’s not that the courts are ordering too many of these reports. The issue is that there are only a handful of doctors that can do them and they have to do it in conjunction with the work they already have,” Ms. Robertson said. She said the issue is part of a much wider problem of lack of mental health care generally in the Cayman Islands. 

“There has been a pressing need for a long time for a long-term psychiatric facility on the island. If we don’t address this, we are going to be looking at more problems later on,” she said. 

Justice Charles Quin earlier this month described the lack of mental health care and facilities for prisoners in Cayman as a chronic situation that needs urgent attention and resources. 

He said, “The criminal justice system is faced with a marked increase of defendants with serious mental issues and they must be addressed as a matter of urgency. It can’t go on. It’s a chronic problem.” 

In a separate sentencing judgment, again this month, Justice Quin also lamented the lack of a rehabilitation program for sex offenders at Northward. 

Ms. Solomon said the prison service is working on introducing such a program, which will be implemented once a new clinical psychologist is hired. 

She said the prison has four qualified counselors who received training earlier this year from Liam Marshall, a Canadian doctor who specializes in dealing with violent and sexual offenders. 

She said, “For the prison service, the plan is to evaluate each prisoner to identify their rehabilitation needs. Identified sex offenders will then be assigned to a treatment program in an effort to reduce the likelihood of re-offending.” 

She said partner agencies in the Department of Community Rehabilitation, the Health Services Authority and the private sector have also received training and will be involved in working with the offenders after their release. 

There is a shortage of psychologists to deal with prisoners at Northward. – Photo: Brent Fuller