MAY PEN, Clarendon— Under-resourced, under-staffed and overworked. That is the reality of the mental health system in Clarendon, according to the parish's Mental Health Nurse Practitioner/Nursing Supervisor Kevin Allen.
He is concerned that his team is being forced to cater to an increasing number of patients with very little resources.
According to Allen, in 2010 the Lionel Town Health Centre had a little more than 55 clients on record that receive care on a monthly basis. In 2020, before the onset of the novel coronavirus pandemic, that figure climbed to 100. Two years later, post-pandemic, the numbers are now up to 150 patients.
"And that is just one clinic. My staff in the mental health service currently comprises of six nurses, one psychiatrist that is responsible for all the hospitals and primary health-care services in Clarendon, and one doctor assigned to all the communities. Just to put things into context, there are three hospitals and 32 health centres in the parish. We have seven child and adolescent mental health clinics from Spalding to May Pen every month. We have over 650 patients that must be visited house to house every month, the six nurses have to work Sunday to Sunday, so please understand what we are dealing with," he lamented.
Allen was speaking with the Jamaica Observer against the backdrop of reports that a 60-year-old mentally ill woman from the parish allegedly set fire to the house she shared with her husband, who is in his 70s, leaving them both homeless. He is concerned that his team is being seen as ineffective when in fact they are simply lacking resources.
"The minister gave each parish a bus and say, 'When you are in trouble, call the bus.' But when you call the bus there is no staff assigned to it so it is the same staff that I have to do the clinic, see the adults, see the children, and then go drive the bus house to house," Allen explained.
With staff stretched thin over a geographically large parish, he said, some patients fall through the cracks.
"So for example the team may be in Rock River in the north and get a call from Lionel Town in the south and we are not able to go because if we abandon the mission [in] Rock River and go Lionel Town, somebody going to call and say someone acting out because they never get their medication. It is the same staff morning, evening and night. The concept when the bus came was that the bus will be parked at May Pen, waiting on a phone call and then they go. But that's not the case; the bus is on the road working every day and sometimes in the middle of treating someone we may have to stop, take them to the hospital, and go back," Allen said.
"So when you look at the physical strain it puts on you, it's not worth it because sometimes you walk into a home and a person gets rowdy, you have to put hand on them to administer the medication, and that causes physical exhaustion. The mental health team is willing and able but we don't have the human or physical resources," he bemoaned.
For the team to be highly effective and efficient in carrying out its functions it will need three more mental health officers, five psychiatric nursing aides and another bus, he said. He added, however, that previous appeals for additional resources have yielded no results.
"I have all the justifications to share that I have written seeking additional staff, but because of the compensation review the Government isn't hiring new staff even though we have been negotiating for assistance for a while now because we know the work is out there," he said.
Parish manager for the Clarendon Health Services, Joseph Grant told the Observer that, over the years, there have been efforts to increase the number of staff for the mental health clinic. He too noted the increase in the number of those in need of care.
"As for the number of patients that have grown exponentially, that is a concern we have at the parish and even regional level and it is something that the ministry is fully aware of. We are working on the staffing but there is an approval process that has to be done by the ministry, and as soon as that is done then the staff should be in place," he said.
He expressed concern, however, that there may be other hurdles to overcome.
"I know the ministry is currently working to improve the number of mental health clinics in the parish and the number of persons to work, but are these staff readily available?" Grant questioned.
He pointed to concerns about whether there are trained workers seeking jobs within the local system and the impact that the required sign-off from the health ministry may have on the time it takes to complete the hiring process.
"These are genuine concerns for us and we are working to improve the facilities for the mental health patients that come for our services. We understand the concerns and we are trying to fix them in a reasonable time," Grant assured.
Meanwhile, despite the very real challenges they face, Allen said, the mental health team continues its work. They collaborate with the Clarendon Health Services for outreach programmes in churches, schools and other community-based organisations across the parish. The team is already preparing for National Mental Health Week that will be observed from October 9-15.
"We will be on the grounds of the Old Police Station in May Pen, starting at 10:00 am. We will pick up the persons on the street, shower them, shave them and give them medical and dental services, look after them and feed them. Three days later, on Wednesday October 12, we will be in Kellits at an expo and mental health fair where similar services will be offered," informed Allen.