THE case of the St Mary mother who confessed to chopping her 11-month-old baby to death at their home on Fort George Road last week brings into sharp focus the gaping holes in the mental health system in the country, stakeholders have said.
For one, it exposes the widespread neglect at various levels of society in preventing those who are ill from perpetrating serious incidents. It also reveals the absence of comprehensive rehabilitative services for those affected.
The mother, known in her community to be mentally unstable and who was reportedly on medication for the condition, is said to have reported her intention to kill her baby to the Annotto Bay police a day before she took action. Last Thursday, she went to the station and confessed to the deed.
"The mother was aware herself that she needed help, but where was the help when she was calling for it? Where was that help? It just doesn't seem to be there," said social activist Yvonne McCalla Sobers, who has a family member afflicted by a mental disorder.
"She asked for help. Help her nuh," she added, appealing belatedly to the police and to members of the woman's community.
The gruesome incident, said McCalla Sobers, could have been avoided if someone had cued in to the mother's needs and separated her from the child.
"If you allowed every cut on your feet to get gangrenous and then say 'cuts cause legs to be cut off', that would not be true. It's neglect of the cuts that causes that," she said, making parallels to mental health issues. The neglect, she said, is not limited to Jamaica, as developed countries are just as guilty.
"For one, there is very little money spent on researching mental health, outside of pharmaceutical companies which have their own agenda. But how can you identify the early signs of illness and what do you do when you identify them? Not enough is fully known about how to prevent situations like this... We need to find some means of doing better research because once the situation is out of hand it creates extreme difficulties," said McCalla Sobers.
The St Mary mother, whose mental problems allegedly surfaced when she lost twins some years ago, will likely be criminally charged and sentenced to a correctional facility, a move which — the contravention of a UN treaty aside — specialists maintain would not be in her best interest.
"For mentally disordered offenders, there are very limited options, as far as that is concerned," forensic psychiatrist Dr Clayton Sewell told the Sunday Observer.
"The treatment and rehabilitation services as they currently exist are not comprehensive; a lot of the services are rudimentary... and are offered through correctional services," he added.
Dr Sewell said he was not protesting the mother being charged in the death of her child as, "there must be a decision made through the courts as to her responsibility for the act". However, he feels wide-ranging treatment has to be part of the process if she is to recover and if similar incidents are to be avoided in future.
"In that type of situation, it is my learned view that treatment has to be a major focus of it," he said.
"If it is the mental illness that caused the behaviour, in my view, treatment — and associated with that is the reduction of the risk of this happening again — has to be the focus, because the fact is that if the person has a mental illness, it is not that the person had a guilty mind to do the particular act, but it would be the influence of the illness to cause her to behave in a certain way," he said.
"The debate is where and which treatment might be available, but based on our current set-up there are very limited options as far as I'm concerned," said the forensic psychiatrist, referring to the absence of a designated forensic mental health institution in Jamaica though previous administrations have mooted building one.
For McCalla Sobers, treatment has to be less focused on drugs and more on talk therapy.
"We need to research the side effects of the medications that people are taking. Some of these side effects can make the illness worse; some increase suicidal ideation, but we just don't seem to be aware, or want to be aware, of some things.
She said while medication plays a role in at least keeping people stable, it alone will not prevent situations like these. And it won't deal effectively with the mother's pain and trauma.
"Even if the mother recovers, she will still have trauma. She gets better, but 'what happened to my child' is still with her.
"I feel very sad for everybody; for the family, for the mom, for the baby," she said.