Barnaby’s rehabilitation mission

Dr Loraine Barnaby, consultant psychiatrist and senior lecturer at the University Hospital of the West Indies is, on a mission to save the lives of substance abusers. And though she has been doing this for several years, Barnaby still gets satisfaction by stabilising people who were once on the edge. Each time, she does so with renewed energy.

“I have no doubt this should be my life’s work as my interest in psychiatry goes way back,” she said, seating us into her small office at the Assessment, Detoxification and Rehabilitation (Detox) Unit of the University Hospital of the West Indies.

It is an exciting day for the five resident patients under her care. It’s Family Day when the programme participants get to share their experiences with invited relatives.

The four men who are at varying stages of the recovery process quickly arrange themselves in a semicircle. Dr Barnaby takes her seat in the centre of the room, which is lightly furnished, yet adorned with poster boards that speak to the signs, symptoms and dangers of substance abuse.

The session begins and the residents speak positively of their progress, reflecting on where they are coming from and what they hoped to achieve.

“Doc, you know that we have the inner power to help us go through,” Leslie, who opened the discussion, said confidently.

A crack/cocaine addict for over 20 years, Leslie said he tried desperately to stop, but just could not. But this time, through the help of the unit, he vows to remain clean.

“I know my triggers, and I know what not to do — don’t get lonely and don’t get angry,” he offered in a high-pitched tone.

David is the youngest member of the group and was brought in by his mother. For 10 years, he was addicted to cocaine. How has the unit helped him?

“For me, it is through behaviour modification. I used to smoke when I couldn’t deal with stress, money stress,” he told All Woman. “I still don’t have any money, but I don’t feel stressed out,” he added.

Beres is 53 and has 18 days of therapy left before he faces the “real world” once more. His problem was alcohol dependency.

“I couldn’t stay away from white rum. I was drinking constantly because it gave me a feeling of comfort. But one day, I just decided to come in. Since I am here, I have learnt so much about self-confidence, and I have a better understanding of myself,” he admitted.

Rohan — the fourth man in the group — had slipped out and did not join the discussion while Marcia, the only woman in the group, declined to join in.

“Women are rarely admitted in the unit,” Dr Barnaby explained. “For one, fewer women tend to get addicted, and those who do usually have family support or someone to care for them. Most of them have children and find it difficult to fit into the residential programme.”

Although each patient at the Detox Unit has a different story, they follow one basic rehabilitation programme designed by Barnaby.

“My interest in drug abuse began years ago while I was doing my advanced degree in psychiatry,” she related. “In 1979, I did a study on drug abuse in schools, although at that time cocaine use was not widespread in Jamaica, but some students were abusing alcohol and tobacco. Out of this I of set up a drug awareness committee in the Ministry of Health and worked on a proposal for a national drug abuse prevention programme,” she explained.

Barnaby’s proposal was successful and was the first preventative project to attract funding from the United Nations Fund for Drug Abuse Control. She was appointed director of the project which, she said, became a springboard for prevention and awareness programmes here and throughout the Caribbean.

The rehabilitation of drug-dependent persons was one of the major planks of her study, and this is what the Detox Unit is all about. Opened in 1991, it provides a therapeutic, drug-free environment for both men and women. Eight persons can be accommodated for residential care over a four-week period. There is also an outpatient facility, which is accessible two days each week.

Prior to being admitted, patients are screened and assessed.

“We look at a number of things…age, how long they have been abusing substance, as well as their mental and physical health,” Barnaby outlined. “We find that alcoholics usually fall into the older age groups while tobacco and cocaine abusers tend to be younger persons.

The programme is divided into three parts: Phase One focuses on helping the patients develop trust and an understanding of self, for example, their thoughts, feelings, attitudes, defences and behavioural patterns and awareness of responsibilities to self, family and community; Phase Two involves group therapy, where the focus is on developing positive interpersonal relationships and involvement in support groups such as Narcotics and Alcoholic Anonymous; while Phase Three focuses on preparation for reintegration into family and community, relapse prevention and development of refusal skills.

At the end of therapy, the patients re-enter society and that’s when they are truly tested.

“The relapse rate is not very high, as most of them go out with coping skills and higher self-esteem, which help them to deal with various situations,” Barnaby noted. “Tobacco or smoking cessation is of particular relevance to their rehabilitation, because most people coming in have a smoking problem.”

Dr Barnaby employs a number of techniques including hypnosis to get her patients tobacco and cocaine free. The brain, she says, will accept suggestions more when it is in a state of complete relaxation, so under hypnosis patients are offered the best solutions to quitting their habit.

Always researching for new ways to improve patient care, Dr Barnaby is anxious to introduce acupuncture and dance to her programme. An accomplished dancer herself, who trained with a number of persons including the late Madame May Soolish, Monica McGowan and Earl Delfosse, she is equipped to offer instructions.

“I really want to introduce these techniques as well as bio-feedback the treatment of drug addiction abuse, but it takes resources,” said Dr Barnaby. “These techniques have been tried and proven abroad.”

Barnaby, who completed her post-graduate studies at Yale University, is in the process of launching “Operation Rebirth”, a programme of activities including computer training and reading courses for in-patients aimed at increasing their marketability. The brain child of Keron Morris, final year student at Caribbean Institute of Mass Communications, the project will also cater to the spiritual upliftment of patients witin the Unit.

Apart from her full slate of responsibilities at the hospital, Barnaby is also an accomplished writer, and has won several awards from the Jamaica Cultural Development Commission for her children’s stories.