Cayman’s first residential mental health facility will comprise nine cottages with six beds each and an administrative building on the former Northward prison farm site on 15 acres in East End, officials revealed Friday, adding that construction on the first seven cottages could start as early as the end of the year.
Costs to build, fit out and open the facility are pegged between $10 million and $15 million, with operating costs estimated at $1 million annually, said officials, who are looking toward and early 2019 opening.
Ministry of Health Chief Officer Jennifer Ahearn said Friday the as-yet-unnamed facility would be “on a parcel of Crown land in the East End interior on approximately 10 to 15 acres of land,” and would “comprise nine cottages, each having six inpatient beds, plus an administrative building.”
“The estimated size of the cottages and the administrative building is 47,000 square feet,” she said, and would accommodate “the chronically mentally or the severe mentally ill … i.e., persons who have serious and persistent mental illness requiring care in a holistic, safe and secure environment using a therapeutic approach.”
Government has for years pondered the need for long-term mental-health facilities. To date, the only option has been eight Cayman Islands Hospital beds, intended for short-term stabilization of acute cases. Longer-term care has been either at Northward Prison or a Jamaica-based residential home.
As many as 15 Cayman patients are in long-term care in the U.S. or Jamaica, primarily Bellevue Hospital – some for as long as two decades – at an annual cost of $630,000. Between 12 and 15 more are either at home or at the Cayman Islands Hospital, and between six and 12 more are housed at Northward.
“The initial phase is to construct the seven cottages for local requirements (non-medical tourism) first,” Ms. Ahearn said. “The proposed time line is for construction to take approximately 16 months once initiated.
“At this point in time, we are finalizing the contract for the design and construction costing of the project, and once we have the design and projected construction cost, we will need to seek funding from Cabinet for the construction of the facility.”
Dr. Marc Lockhart, chairman of Cayman’s Mental Health Commission and longtime advocate for a local long-term facility, acknowledged that years of effort had yielded only modest results, but said this is the long-overdue breakthrough.
“This has been my passion for 16 years,” he said. “The community has needed a long-term facility,” not least “to bring people back home to the Cayman Islands.”
The glacial pace had been frustrating, but slowly, particularly in the last five or six years, he said, “a groundswell has galvanized people and started to resonate in the community.”
Both the Ministry of Health and KPMG consultants had drafted strategic outline and business cases. “Last year, we met with Cabinet and a budget was approved,” complying with the U.K.’s 2011 Framework for Fiscal Responsibility, demanding transparent tendering and value-for-money justifications.
“This all slowed the process,” Dr. Lockhart said, “but now we are into the final stages of the FFR process after two years. We have chosen an architect and a consultant for costing and design and are in the last stages to find a contractor to build it.”
He rejected suggestions that government sought political advantage ahead of the May 24 election, saying, “No, this has been ongoing since last summer’s outline business case.
“We had to make sure bidders were properly composed in terms of employment, Caymanian participation, and had the right structure. In some cases, we had to go back and they had to reapply. We were only able to complete the vetting process in January. We had to submit and resubmit financing plans,” he said.
Ms. Ahearn detailed five aims for the facility: To establish … a therapeutic setting providing counseling, psychiatric care and management, vocational, educational and social skills training; to support and develop independent living skills, allowing patients to rebuild their lives through the development of new employment skills to enable them to return to a functional level through various means; to create an environment in which patients are close to their family and friends, remaining in the community, thus enhancing their social structure and quality of life; to achieve optimal outcomes while at the same time realizing significant operational cost savings; and to allow for adequate clinical oversight of patients, increasing chances of positive long-term outcomes.”
Dr. Lockhart said the East End farm – formerly cultivated by Northward inmates but abandoned after the March 2009 murder of 21-year-old Sabrina Schirn by prisoner Randy Martin – would enable rehabilitation in a quiet environment, distant from neighborhoods.
“It will offer occupational therapy, gardening, small-animal care, woodworking, education, a bakery, a gift shop,” Dr. Lockhart said.
Construction and operating costs might pay for themselves, he said, indicating beds could be allocated for medical tourism, and costs eliminated for overseas boarding and treatment of Cayman patients. Nor would the project require full budgeting all at once.
“We are also looking for private sector involvement,” he said.
“It would also free up facilities at the Cayman Islands Hospital and make more beds available for children and outpatients.”
Staff would comprise one or two full-time nurses and a doctor on selected weekdays.
“This is the farthest along we‘ve ever been,” Dr. Lockhart said, “and with the FFR approval, we are farther along than other projects like the [cruise-ship] port or the dump.”
Premier Alden McLaughlin confirmed in the Legislative Assembly on Friday that a site had been identified for a long-term mental health facility and that government would “soon” be awarding a contract for the design and construction cost consultancy fees for the project.