FOUR parents of mentally ill adult children in Linstead, St Catherine, have issued an impassioned plea to the Government to assist them with caring for their relatives and dedicating a space at the Linstead Hospital in the parish to treat mental health conditions.

The parents, who requested anonymity because of stigma associated with mental illness, from a position of desperation, told the Jamaica Observer that they are living in constant fear and just want greater access to health care for their children, who are often uncontrollable when they have episodes as a result of bipolar disorder and schizophrenia — the two named conditions affecting their offspring.

“I am going to kill you, I’m going to chop you up and burn down the house!” are the words one parent said her son has repeated to her.

She added, “My son lives on the street. He will wake up, put on clothes, sometimes tidy himself, and he goes on the road and he begs for the whole day. Sometimes his approach is aggressive and anyone will feel threatened because this is a big, strong 41-year-old man, and he looks scary because he will threaten you if you don’t give him money,” one of the four parents said.

The dejected parents say access to care for their children has been inadequate, difficult, and expensive.

They also say the designated mental health clinic in Knollis, Bog Walk, is too far away and the transportation cost is too high.

“We have a mental health clinic in the Knollis area, which is about four miles from Linstead town. Almost all of these people are unable to find taxi fare. Approximately, for the day, a little more than $800 for the day to go to the clinic and come back. If you live further than there, you have to pay more. So call it $1,000 per day if you live outside of Linstead,” one parent said.

“What we need is accessibility to the service. The mental health officers of the mobile unit come once a week on a Tuesday and normally reach there by 10:30 am/11:00 am and administer injections,” the parent added.

The parents also claim that presently there is no dedicated vehicle for St Catherine to carry out services for the mentally ill, as that vehicle crashed some time ago. However, they say there is a vehicle that comes into the area in Linstead with mental health personnel who give out injections.

“The problem that we have is that it is difficult to catch a mentally ill person. They don’t stay at one place; they roam the entire community. Most of them are living on the street,” one parent said.

One of the mothers pointed out that she cannot get any assistance from the police when her son is “off” as the police have told her they are not trained to deal with mentally ill people.

“My son has been ill for five years now, so I know that we have to be there for them. We don’t want to abandon them, but we need more help from the police. We need more help because the police will handcuff him, restrain him. We can’t go near him. And if I get somebody to tie him up, he’s going to remember, and when he leaves the hospital and come home, he’s going to say, ‘Mi remember when you did get such and such a person to tie me up and them beat me,’ and he will want to retaliate and maybe attack, because he will now look at that person as an enemy, not realising that the person actually helped him,” she said.

The mother also said community members are fearful of her son and she is very concerned for his safety.

“He will go in people’s yard and go in their vehicles, and people will feel like he is a car thief and shoot him. The main thing is that the mentally ill, they are at risk. They are at risk on the street. They will kill and if people feel threatened by them, they will kill them. If you see this big, violent-looking person coming at you with a knife or a cutlass, you’re going to hurt him; you’re going to defend yourself, and this is what we’re trying to prevent,” she said.

Meanwhile, the parents have requested that a 40-foot container be placed on grounds of the Linstead Hospital as a holding area, “where if you know there is an emergency, you can take them there, along with the police, and get them their injection”.

“And if they’re really, really off, in terms of really sick, you can keep them for two days or three days, then the family would take them home. When they get the injection and you send them back home, sometimes they run away from you. As they reach the hospital gate, them gone, and they end up being on the road, sleeping on the road, and coming home naked sometimes. My son got his injection, run away from me, and came back home naked the following morning, and it’s traumatising,” she said, the anguish etched on her face as she recalls the experiences she has had with her son.

A father, who was also present, said the burden is great caring for an adult child who is mentally unwell, particularly accessing adequate health care.

He said the hospital in Linstead is very small and does not have enough facilities for the treatment of mentally ill people.

He believes, however, that the issue is two-fold, as when they do get treatment at Knollis — some distance away — they return to their community to the very things that trigger their mental problem, specifically drugs, and they end up becoming a danger to themselves and a menace to citizens.

“Because of that, we would like to see some provision made for these persons to be taken away from the streets, where they can be facilitated and kept away from the further consumption of drugs that will make them vulnerable to insane activity,” he said.

The father added that he believes his son has become a drug addict, so his mental problems have now become compounded by drug addiction. He says his son claims ganja is the only thing that can get him to sleep.

“We would prefer if there was a facility available in the community that can take these people off the streets and put them away from the drugs that they get connected to. So that’s what we have been trying to get the Government to do,” he said.

His wife added that people need more public education about how to deal with the mentally ill.

“They have no idea what it is to be in a house with somebody who is ill, who is sick mentally. I think our country needs more public education to create awareness and understanding of what is mental illness. You can’t deal with something that you don’t know about. So we are just asking the Government to highlight and to provide more resources in St Catherine for the mental health officers who have to visit to go up in the hills and in the bushes and on some real bad roads to get to these people. It is hard,” she said.

For another mother, the struggle is constant in accessing mental health care for her 40-year-old daughter who has been suffering from bipolar disorder for the past 16 years.

Her child, who lives with her but mainly roams on the streets, is now six months pregnant, but the father of her unborn grandchild is unknown.

She too is crying out for greater access to health care for her child, noting that her daughter is often uncontrollable when she has episodes.

This mother says that there was a time when treatment for the mentally ill could have been sought at the Linstead Hospital, which she said was ideal for her based on where she lives. But now that this arrangement was changed, it has proven difficult to access treatment.

“That is within our bounds, within our jurisdiction, where we can walk and we can make it to the hospital. Now they bring it [the clinic] down to Bog Walk. For me, living in Linstead, I take a taxi to Bog Walk, then I have to take another taxi to where the clinic is located,” she said while also lamenting the expensive taxi fare.

“When them sick and you want to take them to the clinic, it’s not easy to get them into a taxi to get them to the clinic. Most times people have to be chartering vehicles to go to the clinic, and it’s very hectic, and most of these parents are the poorer class. They just don’t have it,” she said.

She says that her daughter can get very boisterous and will fight her at times, and in these instances, out of desperation, she may request the help of the police, but she too is told that the police are not trained to handle these types of situations.

“It would have been much easier if the clinic was nearer, as she get sick, she could get treatment right away. Most times, by the time we are to get around to go to the clinic, it’s a week into the sickness and bipolar progresses very fast. Within two days, three days she will be extremely agitated or she can be extremely distressed,” she said.

Another parent, who has challenges caring for her 27-year-old son who was diagnosed with schizophrenia last year, says she is wary of the once-a-week treatment normally provided for the mentally ill at the clinic and worries about what can happen in between those appointments.

“They only come on a Tuesday, and anything happens prior to the Tuesday, then you would have to take them to the hospital…So when you wait until the Tuesday, even though I have a number for them, which they said it was like an emergency number, I couldn’t call that number and get any form of assistance from them unless it is on a Tuesday, and even if it’s on a Tuesday, I still have to find my way there with him,” she said.

She said this wait period is one of the reasons he has ended up at the hospital at least four times, recalling an episode when he tried to kill her by squeezing her throat and another when he set a line of clothes on fire just after washing them and hanging them out. There was also a time when he was running down vehicles and dancing in the road.

She says getting him to the clinic is challenging as on clinic days he may refuse to go, and when he does go, he will be impatient to leave if not seen right away, and she would have to do all she can to keep him from walking away. He will also refuse to take his medications.

The mother, who believes lack of sleep and smoking ganja triggered her son’s schizophrenia, shared that he is overcoming his illness and is doing much better.

“He has stopped the smoking now…that was the biggest challenge. The smoking part of it. That was what triggered everything,” she said.

In response to the concerns parents have raised in accessing mental health care for their children, Minister of Health and Wellness Dr Christopher Tufton said that the Knollis clinic, which is held every Tuesday, sometimes accommodates over 100 patients.

“Every Sunday is outreach for patients who cannot come to the clinic in the areas across Flat Bridge,” he said, noting that when the team is aware of patients urgently in need of medication they are at times facilitated out of schedule.

He noted as well that it is common practice for medication to be taken to the patient, and there are also exceptional cases in which a known family member is allowed to collect medication for the patient.

When asked if the ministry would consider putting a container on the grounds of the Linstead Hospital as an additional space to treat mentally ill patients, Dr Tufton responded that he would ask the South East Regional Health Authority to “look at it”.

Regarding the availability of vehicles, Dr Tufton said the ministry is in the process of procuring two new mental health units for the parish, noting that the unit assigned to the parish is working.

Meanwhile, a police officer who has been involved in situations with the mentally ill, which he says do not normally end well, reiterated that this is not an area the police are equipped to deal with and suggested that more mental health officers be trained to respond to such emergency situations.