‘Frustrated’ Dr. Marc Lockhart leaves Mental Health Commission post

Frustrated by a lack of communication and the slow pace of progress in addressing Cayman’s “mental health crisis” Dr. Marc Lockhart has opted not to return as Mental Health Commission chairman, a decision which he says was not easy to make.

“I do not feel that we as a community are doing enough from a mental health standpoint. I feel that statements are made, words are spoken but the action aspect of things falls way below what is spoken,” Lockhart said as he explained the rationale for his decision to the Compass.

His term as commission chair expired at the end of December. There has been no word on his replacement.

The Compass has reached out for comment on Lockhart’s departure from the Ministry; none was provided by press time.

Decision fueled by frustration

Lockhart assured his decision was not a result of conflict or infighting with his colleagues on the commission, but he said he felt like he had “hit a wall” and could go no further in the role.

“The Mental Health Commission has supported me and they’re very upset with me not continuing with them and I understand that, but I felt that this is the only way to make progress for those that need it,” he said.

He said remaining, and maintaining the status quo, is not going to work.

“Writing, trying to get things… no answer, no clarity, no appreciation of the level of work that is required to run a 54-patient facility…” he listed, as some of the reasons he decided to step away.

“Based on where things are currently, I did not feel that the level of communication that I was receiving from the ministry was adequate – especially based on the mental health crisis that we are experiencing in this island, in our region and in the world as a consequence of COVID and the aftermath,” he said.

Cayman, he said, has seen sharp increases in mental health issues especially involving young people. Yet, the community is still forced to work with the existing, limited capacity.

“Suicide attempts among teens… went up by 72% between 2020 and 2021. We had over 100 suicide attempts among young people during that year. We’re still dealing with the aftermath of that. We still only have 11 beds for our total population,” he lamented.

At present, he said, those beds at the Cayman Islands Hospital are full.

“We are walking the walk but we need to jog a little bit. We need to run at times, we need to pick up the pace… We are seeing in our region and our world there is greater instability, that puts pressure on our services,” he said.

‘Major construction’ complete, but no plan in place

Lockhart has been pushing the construction of a long-term mental health facility for years. Finally, the “major construction” has been completed, but he stressed the physical structure is only a small part of the facility.

The $15 million facility consists of cottages with two major buildings and sits on a 50,000 square feet site in East End.

The facility initially broke ground in October 2019, with a projected December 2021 completion date. However, the COVID-19 pandemic delayed construction for a year, along with several other capital projects.

He said lack of movement to resource the facility properly is fuelling his frustration.

“There are no plans for staffing, there are no plans for preparing the facility to receive the patients. There are no plans for training, for hiring staff, for job descriptions. In order for us to properly move forward, we need to have clear plans, clear communication, clear strategy about what is required,” he said, adding he is not getting this from the health ministry.

“We get the guidance from the political leadership in terms of the minister herself, and others that entertain us, discuss things and push for certain things. We, the Mental Health Commission, as the advisory body, can give advice and information… We’ve helped every step of the way in terms of guiding this facility,” he stressedd, but said getting the facility to the next stage has been a struggle.

The commission, he said, has written multiple times to the ministry offering to meet with them.

“We’ve sent in plans as to how things should be done to get the facility properly opened,” he said, but there has been nothing forthcoming.

Mental health crisis needs attention

Lockhart said, at this stage, he believes he can do more to fight the mental health crisis on the font line in the community, rather than in the commission.

“This has been my passion. I’m not a politician. I’m not trying to embarrass anyone. I’m not trying to score points. I am trying to improve the mental health system of the Cayman Islands,” he explained.

And he will not stop fighting for patients.

“Before there was even a Mental Health Commission, this was my passion and my advocacy… I will continue to advocate for those in need, those who have mental health challenges, and work with the community to actually get the facility open and running the way it should and to address all the other challenges that we have… we have severe challenges,” Lockhart said.

Cayman, he said, currently has 12 patients in a facility in Jamaica and some in the US and they, together with their families, are pleading to get care at home.

The facility, he said, is desperately needed and cannot afford to be stalled.

“All of the normal stressors we talk about – the problems with migrants, the problem with traffic, the problem with young people trying to afford homes in Cayman, the problem with our beach erosion and our ability to enjoy our environment… have emotional and mental health repercussions. The solution cannot just be to send people overseas when they need that type of treatment,” he explained.

The burden is being put on the mental health providers, staff at the hospital and private providers, he said and this is where central government has to step up.

The private sector, he said, has been doing the innovation in the mental health sector such as the opening of the LOUD Silent Voices group home.

Lockhart also lamented that lack of appreciation has been an issue for those in the healthcare field.

“Throughout this whole pandemic, when we had the hotline and so forth, it was manned by different volunteers and when something did arise and somebody had to go to the hospital, it falls back on the psychiatric treatment team at the hospital, that’s it,” he said.

“We have not been given necessarily all the resources that are required. There’s a serious challenge with burnout among our doctors and I haven’t heard anyone really address that and say ‘I thank the nurses that are there in the emergency room,'” he stated.

Lockhart vowed to continue his psychiatry work in the community and advocate for those in need.