Dr Maureen Morgan provides strong medicine for the mentally ill
Recently, the news of Andrea Yeates, a 36-year-old mother who drowned her five children in Houston, Texas focused much attention on mental illness, and in particular, postpartum depression. While this scenario is far-removed from our everyday experiences, mental illness affects many persons in Jamaica. This week’s All Woman highlights the work of Dr Maureen Morgan, senior medical officer (SMO) at Bellevue Hospital.
When Dr Morgan decided on a career in medicine, she was driven by a strong desire to find out why people became ill and what could be done to make them well again. She was also curious to understand how the mind works and the distorted web of reality that characterises mental illness. What she did not envisage was that today, she would have the direct responsibility for the planning and delivery of health care for the largest mental health facility in the island.
Regional psychiatrist for the South-East Health Division, Dr Morgan went through her paces at the University of the West Indies to become a general practitioner, before pursuing post-graduate studies in psychiatry. “When I graduated as a general practitioner, I worked at Bethel Baptist Church Clinic and saw many persons who needed counselling and were suffering from various forms of mental illnesses, and this further piqued my interest in this area of medicine,” Dr Morgan shared with All Woman. Having worked her way through the matrix of psychosis, she has taken on the challenges of Bellevue, while maintaining a private practice, lecturing at the University Hospital of the West Indies, and consulting on a number of medico-legal cases which involve the psycho-analysis of persons on criminal charges.
She outlined some of the main psychotic and neurotic illnesses that compromise the health and well-being of many persons in Jamaica, as well as treatment options that are available.
“People think of mental health as just madness, which is clinically-speaking, schizophrenia or psychosis, but there is much more to it. Schizophrenia is an illness, which involves disturbance of the thought process caused by chemical imbalances in the brain. People will hear voices, they will perceive threats where there are none, and it is a very disturbing illness which affects people’s ability to function, and this condition affects only about one per cent of the patients we see.
“But there are other types of disorders which are just as debilitating. The other 99 per cent of the cases we are dealing with are depression and anxiety. These include obsessive compulsive disorders, panic disorder, personality disorders-manifested in the way these persons relate to self and others. There is also substance abuse disorders, which usually co-exist with other disorders such as general depression or dependent personality disorder,” Dr Morgan told All Woman.
Depression, she said is most common among women, and is usually characterised by sadness, irritability, lack of energy, sleep disturbances, lack of interest in things that they usually enjoy, a negative outlook on life, decreased sex drive, with the individual becoming withdrawn. She also outlined factors such as heredity, lifestyle changes such as a significant loss, broken relationships, job-related stress substance abuse, early parental loss, the postpartum period, premenstrual syndrome and the onset of menopause as red flags for impaired mental health.
“Some personality types are also prone to depression. For example, people who are dependent, or are harsh and critical of self. We also see persons with bipolar disorders or manic-depressive mood disorders, who go in cycles from highs to lows,” Dr Morgan further diagnosed.
“If these chronically-ill persons go untreated, they spend years merely existing, and become unproductive as they tend to have very low energy levels,” she continued.
The challenge Dr Morgan faces, therefore, is to build and develop a comprehensive mental healthcare programme which is inclusive of in-patient and out-patient care, rehabilitation programmes and the provision of special residential facilities for the chronically ill patients.
“It is an approach that seeks to integrate mental healthcare into primary healthcare programmes. A lot of attention is being paid to in-house care because in order for people to remain well in their community they need support in the form of jobs and supervision, with respect to living arrangements,” she outlined.
She is presently eyeing the Salvation Army facilities in downtown Kingston which she says, could be developed as a residence for some of the mentally-ill street dwellers. She is appealing for help, especially from private sector concerns in the area.
Another major issue for the SMO is the stigma attached to mental illness, and fear of the illness which, together work against the presentation of cases and the rehabilitation process. Dr Morgan explains that the need to stress mental health as an important part of healthcare delivery is critical.
“Getting people to understand that ‘mad people’ are clinically ill and in need of medication, care and protection is something I am deeply concerned about. Recently, we have also trained a group of police in the South East region to equip them to work along with health care workers on all spectra of the problem.
“Each weekend, a team of officers and healthcare workers go out and take in a number of street persons. They are fed and given medical attention, some remain while others go back on the streets. Many are migrants from the rural areas who have nowhere to stay in Kingston so they live on the streets. There is, however, the need for alliances with non-governmental organisations, the private sector, churches, service clubs, schools and other community groups to meet needs of growing population of mentally-ill among us,” she revealed.
A hard worker and strong advocate for the demented, Dr Morgan was instrumental in establishing, with the help of the Multi-Care Foundation, a child and adolescent psychiatric service at the St Jago Park Health Centre in Spanish Town and the newly-developed Rainbow Centre at Bellevue. In terms of treatment options, she said that medical facilities (both private and public) islandwide are equipped to deal with all types of cases, and outlined three main categories: use of tranquilisers, anti-depressants, oral and behavioural therapy.
“Contrary to popular belief, the treatment drugs are not addictive, some have a sedating effect, but you won’t get hooked. Talk-therapy is also considered one of the main treatment options to overcoming the illness,” she said. Dr Morgan also had some strong medicine for women. To maintain our emotional well-being as women, we need to get in touch with our feelings, and this is something we need to do on a daily basis by keeping a journal if you prefer to write than to talk; find healthy ways to have your emotional needs met like good friends; club networking, as people who are isolated are at greater risk; develop a hobby, no matter what it is; find something that gives you enjoyment; plan –when you don’t plan, the unexpected happens and you feel stressed; take time out for important relationships and always strive to improve your life.”
Dr Morgan herself enjoys gardening and cooking and “tries to cater to the exotic tastes” of her husband, Orville who is also a doctor, her two sons and two daughters. She is a devout Christian and serves as a deacon at the Mona Baptist Church where she worships.
