THE 145-year-old Bellevue Hospital in Kingston is among the sites being considered for a proposed forensic psychiatric prison for Jamaica’s criminally insane, the Ministry of Health confirmed earlier this month.

“That place would be one of the considerations,” said Dr Grace Allen-Young, the ministry’s permanent secretary. “We have had an inter-ministerial meeting that has discussed that and other aspects of the long-term plan for the psychiatric services chaired by the Ministry of Justice,”

Bellevue, Jamaica’s premier asylum, has been earmarked for closure for several years now under a government plan to move from the provision of mental health care at the institutional level, to community care.

But there are still more than 800 patients at the hospital, with just under 100 of them acutely mentally-ill, the senior medical officer, Dr Maureen Irons Morgan, has said.

But while, according to Dr Morgan, there are a significant number of patients who have recovered enough to be safely managed at their home, relatives most times reject them.

“Abandonment by relatives is a major issue here at Bellevue. Among our 814 patients, about 500 are geriatric and many have lived at the hospital for decades – 30, 40, 50 years and more,” she said in a written response to queries from the Sunday Observer.

The fate of those patients, should Bellevue be selected as the site for the forensic psychiatric facility, is one of the issues that would have to be worked out.

It is a decision, Allen-Young said, that would have to be made by all the partners in the process.

“We (the Ministry of Health) are involved, but the leadership has been coming from (the ministries of) Justice and National Security, so I am not in a position to say exactly what is to be done. We will have to continue the dialogue,” she said.

Prison boss, Major Richard Reese, had first spoken about the establishment of a forensic psychiatric facility last December, saying at the time that one of the island’s medium security facilities, Tamarind Farm, was being looked at as a possible location. At the time, Tamarind Farm was under-going a $35-million upgrade.

The planned forensic psychiatric facility will treat mentally-ill persons who have broken the law or who, otherwise, are already in the prison system and are deemed to be a threat to themselves or to others.

Up to December last year, the criminally insane in the island’s prisons numbered close to 200. The crimes for which they were incarcerated ran the gamut of arson, rape, murder, malicious destruction of property and wounding.

At the time, the correctional services said it was costing an estimated $500,000 annually for their individual care. The cost of caring for regular prisoners was $450,000 per inmate.

The differential, Reese explained at the time, was due to the cost of medication. Mentally-ill inmates, he said, con-sumed approximately 30 per cent of the medication, accounting for $2 million of the $7 million spent on pharmaceuticals annually.

More than a year into the planning for the facility, there is still no clear indication as to what it will cost to set up. In fact, Allen-Young said that the decision-making process was far from complete, with details such as the final cost and design of the facility, once the location was approved, yet to be finalised.

“Those decisions have not been made yet,” she said. “We are still exploring what should be done, where it should be,” she said.

Reese, for his part, said that he was awaiting input from the Urban Development Corporation (UDC) on the matter.

“I am awaiting technical information from the UDC on the general layout of the building regarding a prototype facility pre-viously constructed,” he said. “The information will assist us in the planning and the cost.”

He made it clear, however, that there was still no final word as to the precise location of the facility.

williamsp@jamaicaobsever.com