The first report of Cayman’s newly formed Mental Health Commission states that nearly 4,000 people – 9 percent of whom are age 17 or younger – received some form of mental health-related services at public, private or overseas hospitals in 2013.
Premier Alden McLaughlin, who is also the Cayman Islands health minister, said Wednesday that he believes there is an adequate number of healthcare professionals on Grand Cayman to meet patient needs.
However, the lack of a long-term mental health patient-care facility in the Cayman Islands and a dearth of mental health practitioners on Cayman Brac continue to be daunting problems for the islands, the premier said.
“In 2013, almost 4,000 patients were treated in the government and some outpatient private facilities, of which 9 percent were children and adults 17 years of age or younger,” Mr. McLaughlin said Wednesday during his discussion of the Mental Health Commission’s 2014 report in the Legislative Assembly.
“While there is an adequate number of mental health practitioners, psychiatrists, psychologists, mental health nurses, occupational therapists, etc., employed in [the] public and private sectors, the distribution of human resources among the three islands is disproportionate as there is no psychiatrist, psychologist or occupational therapist located on the Sister Islands,” Mr. McLaughlin said.
The nearly 4,000 patients represent individuals, not the number of patient visits recorded for the year. However, it should not be interpreted to mean that there are nearly 4,000 people in the Cayman Islands with serious, recurring mental illness, said the health ministry’s chief officer, Jennifer Ahearn.
The number represents anyone who has sought some form of mental health service, including short-term treatment with psychologists or counseling visits in times of grief or tragedy, for example.
According to the government’s records of registered healthcare practitioners, there are six mental health professionals, 13 psychologists, seven registered mental health nurses and four psychiatrists in the islands.
“These numbers, though not ideal, put the Cayman Islands in a better position for human resources in mental health than many other countries in the region,” Mr. McLaughlin said. “Our resources should now focus on improving community mental health services, as well as increasing the outpatient services in our hospitals.”
The premier said government would issue a request for proposals in September or October seeking a consultant to establish an outline business case for a new long-term residential clinic for mental health patients. Government apportioned about $1 million for the development of the new clinic in the 2015/16 budget.
Now, people who need long-term psychiatric care must leave Cayman for an overseas residential care program. The health ministry has reported that 10 to 20 Cayman Islands patients require overseas treatment for mental illness each year, and another 10 to 20 patients cannot go off island for care because of criminal convictions.
There are eight beds for mental health patients at the Cayman Islands Hospital, but that is not a long-term facility, and patients released from hospital often end up back on the streets or in jail.
One particular case working through the local court system earlier this year revealed unsuccessful efforts to treat a robbery defendant for bipolar disorder and served to highlight Cayman’s mental healthcare deficiencies.
During an April court appearance in the case, Grand Court Justice Charles Quin described the increasing number of court cases involving defendants with mental health issues as a “chronic problem” that had to be dealt with as a matter of urgency. In the specific case, the defendant’s lawyer also pointed out what she described as failures on the part of the police and health services to help her client.
On March 23, the defendant, who is not identified by the Cayman Compass, was brought to court for a curfew violation. Defense attorney Fiona Robertson said police had seen her client in an area where she should not have been, but rather than arresting her or taking her home, they simply told her to go home.
Justice Quin said it was shocking that the woman continued to interact with drug dealers. The defendant’s supervising officer said the woman did not have the strength to fight the influence of the drug dealers who came to her home.
The defendant asked the court for “one more last chance.” Justice Quin released her with the provision that she wear an electronic monitor and return to court for a review in two weeks.
The defendant was back in court three days later.
Ms. Robertson said the police had seen the defendant out in violation of her house arrest conditions, but did not keep her in custody as they were required to do. As Ms. Robertson understood it, there were no cells available, so the defendant was simply released again.
The defendant, after remaining at home for some time, recognized that she was in crisis and went to the hospital, but she was not admitted to the mental health unit.