Dear Editor,

The following is an open letter to Minister of Health Christopher Tufton:

Stand Up for Jamaica acknowledges your committed and persistent action on the issue of mental illness in Jamaica. Your recent announcement in Parliament regarding the provision of housing for the mentally ill is a step in the right direction and demonstrates bold leadership.

As a non-governmental organisation working in the island’s prisons, through the support of the European Union, we come face to face with the horror that the mentally ill face in prison when there are no alternatives for them.

The fact is that solutions for the mentally ill should begin at the community health care level before the cases, as they inevitably do, end up in the hands of the Department of Correctional Services, which is ill-equipped to deal with the mental health care needs of these individuals.

The recommendations of the Mental Health and Homelessness Task Force, which you are now seeking to implement, highlighted this logic, and we are pleased to note that you have expressed agreement by the actions you are now taking.

The work of the task force was vital to us as a human rights group as it shed light on one of the most vulnerable populations in the society. The task force was also clinical in its analysis of the mentally ill in prison and proposed solutions which we have been advocating for some time now.

While we understand that the Government faces significant budgetary constraints, we do hope that you will go the full nine yards in implementing all the recommendations of the task force and not just stop at the provision of housing for the mentally ill.

One recommendation of the taskforce which we deem to be the most critical, particularly in respect of our work with the mentally ill in prison, concerns the establishment of a joint team to explore the possibility of transferring those inmates deemed unfit to plead to a transitional facility at Bellevue Hospital.

The task force noted that there is a need for a forensic psychiatric facility for the people who are in prison and deemed unfit to plead, and that discussions have taken place between the ministries of health and national security for the establishment of this facility at Bellevue. We would welcome an update from you on the progress that has been made to date on the establishment of such a facility.

While the task force shied away from looking at models which would prevent individuals deemed unfit to plead from ending up in prisons in the first place, we believe that the Ministry of Health has a vested interest in working with the Ministry of Justice to address this issue.

The work required in this regard need not be costly or difficult as several models were highlighted in a 2004 recommendation by a team, chaired by Professor Fred Hickling, for the introduction of a ‘Diversion at the Point of Arrest’ system to prevent persons with mental illnesses from being placed in correctional institutions. In a submission to Cabinet, in March 2004, the Hickling team, from the Department of Community Health and Psychiatry at The University of the West Indies, Mona Campus, urged the Government to promote a process of community health intervention which would divert mentally ill accused persons from the criminal justice system.

We strongly renew calls for such a system and welcome any opportunity to work with the Government to make this a reality.

Carla Gullota

Executive director

Stand Up for Jamaica

sufjmedia@gmail.com