CONSULTANT forensic psychiatrist Dr Myo Kyaw Oo, who has served the correctional services for over two decades, has highlighted the “enormous demands” facing the skeleton crew of psychiatric experts who have been saddled with furnishing hundreds of reports ordered by various courts islandwide for individuals in conflict with the law who appear to be mentally challenged.

Speaking at a recent mental health symposium hosted by the St Mary Parish Court, Dr Oo said with the influx of orders for fitness to plea, fitness to stand trial and fitness to be sentenced assessments, detailed psychiatric reports or comprehensive forensic psychiatric reports, “the role of forensic psychiatry and forensic psychiatrists, forensic psychologists and clinical psychologists become very significant in the legal matters of hearing, conviction, sentencing, disposal and acquittals”.

According to Dr Oo, the skeletal staff has its hands full contending with existing and incoming cases.

“Currently as we speak… inside our Department of Corrections we have only five psychiatrists full-time. I am a contract officer. So including me, there are five people dealing with these assessments. There are two sessional psychiatrists, they are assigned to juvenile facilities. They are not quite involved in the assessments. We have only two registered counselling psychologists, they cannot do clinical assessments and we have only one registered clinical psychologist for your cases of intellectual disabilities. We have one forensic psychologist registered and we have only two registered nurses who have to rotate and give the injections that we order every month,” Dr Oo explained.

“Over 3,000 inmates, 300-plus mentally ill, 160-plus unfit to stand trial, 40 ‘court’s pleasure’ cases. So the demands are enormous,” the forensic psychiatric expert outlined, noting that in one month alone 300 requests for assessments were received.

“In August alone, we received over 300 requests from islandwide courts for five psychiatrists. You can imagine our workload?” Oo said in acknowledging that the uptick in numbers could have been because judges typically proceed on vacation breaks in August.

“So I believe that the expectation is that we’re going on leave a for a month, so therefore by the time we’re ready September, everything should be ready. So what happened is that each court may send five or six requests but on compilation, we have over 300 now,” he explained.

That pressure he said carries multiple implications for staff.

“Psychiatrists become sick. So we are overworked now because each court is calling – ‘where is my fitness? Where is my report? Why didn’t you send it?’” Dr Oo said further, noting that checks sometimes come “courtesy of a polite call” or through subpoenas.

In the meantime, he emphasised that in order to prevent what might appear to be delays or inefficiency on the part of his staff, the courts must ensure that requests are sent to the relevant individuals with the request correctly stated with proper contact details.

“You are requesting a detailed report and the [accused or inmate] cannot give me any information at all. We like to know the reason why they are sent for the assessment,” he said.

According to Dr Oo, the process between the time the court makes the order and receipt by mental health experts is itself often responsible for the lateness of reports.

“When the requests come we compile all these requests….put it in the log system and assign each psychiatrist – five of us to do the assessment – and then we do the submission of all these reports to the court. Now they’re going to ask me now why report is not coming on the due date? Why delay? Well, the date the court letter is written is a different date, the date the letter is carried by the police officer is a different date…[by the time it gets to us] four, five dates passed already. When we receive that letter the court date is tomorrow or next week. So that’s one explanation,” Dr Oo said.

He said locating the prisoner or the accused is another complication at times.

“Sometime when we receive the paper we go to the prison..we look for them, nobody’s there. So we call the clerk of the court or case progression officer and we are told “that person is not in our facility please contact the police officer”. Then when they call the police they say their transportation broke down and the person is still in the lockup and had not been transported to the prison yet,” he explaining further.

Said Dr Oo: “I ask the court case probation officers to ensure to do a follow-up; call the police station ask them if the person has been transported; which day were they transported? Someone must be accountable so that we can do our business, so we can respect the court date also”.

“When we do the assessment we need four to six weeks and validity is only four to six weeks because fitness to plea or unfit to plea can change within four weeks’ time with treatment because so sometimes the person is fit to plea when they leave our facility, but when they are in the police station they don’t get medication so they relapse and when they stand before the judge they are unfit. So now you’re wondering why the doctor saying fit when the man is unfit,” he said further.