Last month, the newly formed Cayman Islands Mental Health Commission raised some eyebrows when it reported that about 4,000 people here had sought access to mental health services in 2013.
Those figures, based on a free assessment by the Pan-American Health Organization in conjunction with a World Health Organization program, may actually be low, Cayman Islands psychiatrist Dr. Marc Lockhart said Tuesday.
“It was about 4,000 people we were able to gain information on,” Dr. Lockhart said, speaking to a group of local journalists and other professionals gathered for a one-day Dart Center for Journalism conference at the Westin resort on Grand Cayman’s Seven Mile Beach. “There were a few private facilities [that PAHO couldn’t get information from], so it may be closer to 4,500 or even 5,000 people … out of a population of 60,000.”
The 4,000-person figure cited in the Mental Health Commission report represents individual patients, not the number of patient visits recorded for 2013, Ministry of Health officials clarified earlier. However, that number should not be interpreted to mean that there are nearly 4,000 people in the Cayman Islands with serious, recurring mental illness.
Dr. Lockhart said Tuesday that only about 10 percent of that number, between 400 and 500 people in Cayman, might be described as having acute, recurring mental disorders, such as schizophrenia.
By far, he said, the majority of mental health services requested were for the more common illnesses of depression and anxiety. For children, attention deficit hyperactivity disorder, also known as ADHD, was one of the more prevalent issues, he said.
The health commission report noted that about 9 percent of the patients receiving mental health services were age 17 or younger.
The government expects to issue a request for proposals this year 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 in its current budget for the development of the new clinic.
Currently, 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. Dr. Lockhart said it was becoming “more and more” difficult each year to find mental health solutions overseas for local patients.
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 for criminal offenses.
Dr. Lockhart told the conference audience that local health professionals often feel as though various situations involving mental health are misreported in the media and are generally not understood by the public.
Using one recent case as an example, Dr. Lockhart said media coverage of an incident in May 2014, involving a topless, machete-wielding woman causing damage at two local businesses was misleading in that some reports referred to her as a “mental patient.”
“Time after time … she has become the example of the failings of the [Cayman Islands] mental health system,” Dr. Lockhart said. “But this woman has a serious cocaine addiction.”
That addiction, and some of the consequences of it, have been reported previously in the Cayman Compass following court appearances related to her case. However, Dr. Lockhart said those mitigating factors are often not reported in the aftermath of such occurrences.
“The propellant that pushes this type of behavior is drugs,” Dr. Lockhart said. “Drug abuse is the biggest issue when it comes to mental health.”
Bruce Shapiro, director of the Dart Center for Journalism and Trauma at New York’s Columbia University, said the difficulty often is that reporting stories “on deadline” does not mesh with physicians’ desire to thoroughly review written reports and discuss “bigger picture” issues.
“We don’t often do ‘issues’ in a big, murky way,” Mr. Shapiro said. “Mental health is a challenging need, and finding stories can be rather difficult.”