A new report recommends a 42-bed long-term residential mental health facility be built in the eastern districts to serve local and overseas patients with severe mental illnesses.
The outline business case for the mental health facility, prepared by consultants with KPMG and released Tuesday, recommends government build a $16 million facility on 15 acres somewhere in the eastern districts.
If approved, construction could begin as early as July 2017 and a facility could be open by January 2019.
“The current system results in local patients being separated from their families,” the consultants stated in the report. “Community resources and the primary care hospital are under stress from those local patients who are unable to seek care abroad.”
Dr. Marc Lockhart, head of the Mental Health Commission and who worked with the KPMG consultants on the report, said in an interview Tuesday, “The report clearly highlights the need for this type of facility.” He said the facility “will make not just a social difference, but a financial difference.”
“I am delighted that we are now able to proceed with this much-needed facility to treat our mental health patients in a proper and fitting manner,” Premier Alden McLaughlin, who is also minister for health, said in a written statement.
“This has been a long time coming, but my administration is determined to ensure that we achieve this important milestone in the healthcare we provide for our people. Those who require treatment, often the most vulnerable in our society, will no longer have to be sent overseas and separated from loved ones to get the care they need.
“Importantly, instead of patients being locked up, or on the street, we will have the appropriate accommodation to help those who need it most,” the premier said in a press statement.
The solution selected as the best option in the KPMG report is to build a long-term mental health facility on Grand Cayman to treat local and overseas patients, using the mental health facility as an extension of the push toward medical tourism to help cover the operating costs.
The report recommends an initial 42-bed facility to be built on 15 acres on the eastern side of Grand Cayman. The report outlines an eventual expansion to 54 beds. Based on current need, the consultants said, the facility would likely have 12 beds available for overseas patients and 42 for local patients.
Overseas patients could be accepted in the facility, Dr. Lockhart said, “once we make sure we attend to those who need it here first.”
Financial estimates in the report put the cost to build the facility at about $16.2 million. Government’s budget currently under debate in the Legislative Assembly includes $2.5 million for the facility over the next 18 months.
Funding for construction will have to come from government’s capital projects budget, with the bulk of the cost, $10 million, needed between July 2017 and June 2018 for construction.
Annual operating costs, expected to average less than $4 million a year over the next 30 years, will likely be offset by savings in the cost of the current system of treating patients overseas, in the Cayman Islands Hospital and at Northward Prison.
The consultants recommend a campus with a main building and nine cottages for patients, including one that would be handicapped accessible. Each cottage would accommodate six patients.
The initial facility, the report recommends, should have seven cottages and 42 beds for patients. The consultants recommend a modular design that would give the facility the flexibility to expand if demand for long-term residential treatment grows.
The current mental health system in Cayman, the report states, is “not equipped to deal with growing numbers of local patients suffering from mental illness.”
The consultants noted that the lack of resources in Cayman makes it hard for patients to transition back into the community.
The report pointed out that there are 14 patients from Cayman receiving long-term care in Jamaica and the United States, costing government an estimated $630,000 a year. The consultants note that there are 12 to 15 patients either being cared for at home with family or with regular visits to the acute care mental health unit in the Cayman Islands Hospital.
The report also notes that there are six to 12 potential patients in Northward Prison. The consultants noted, “Northward Prison is housing offenders with serious mental health issues in an environment that is not suitable for these offenders, placing significant pressure on prison staff whose training does not prepare them to work with offenders with serious mental health issues.”
The consultants examined five options for what to do with patients in Cayman requiring long-term mental health treatment in a residential facility. Those options ranged from continuing the current combination of overseas hospitals, the prison and the acute care unit at the hospital, to hiring an outside company to build and run a facility on the island.