Helping move mentally ill out of prison not an issue, says TuftonWednesday, November 04, 2020
BY ALICIA DUNKLEY-WILLIS
“Resources and funding” have been identified by Health and Wellness Minister Dr Christopher Tufton as the hurdles that his ministry would need to clear in order to find suitable spaces so that mentally ill prisoners can be removed from correctional facilities.
A recommendation for “some place other than prison” to hold mentally challenged inmates is one of several made in the Mental Health (Offenders) Inquiry Committee report commissioned by Chief Justice Bryan Sykes earlier this year. The inquiry was ordered after the death of Noel Chambers, who had been detained for over 40 years without a trial, turned public spotlight on similar tragic cases.
There are approximately 300 mentally challenged inmates spread across three of the island's adult correctional facilities. More than half of them are listed as awaiting trial.
“We can help in that regard [designating appropriate facilities]; that's not an issue. When the conversation leads to that, then the support is there in terms of determining the criteria for facilities like that,” Dr Tufton told the Jamaica Observer following the release of the report last week.
“We know, based on what is required for treatment and so on, we know what is the ideal scenario. It now becomes a function of resources. One would have to engage a conversation around what exactly is required and what exactly the costs associated would look like,” he said.
By law, Bellevue Hospital in Kingston is the designated public psychiatric facility where mentally ill defendants should be detained. However, this responsibility was shifted to the Department of Correctional Services in the 1970s and has not been corrected.
Dr Tufton said the challenge with Bellevue is that it has become more of an infirmary than a mental health institution “because most of the residents there are there because they have nowhere else to go and Bellevue, at this point in time, is targeted for restructuring and that's the direction that we want to head in”.
The health and wellness minister is, however, adamant that hosting such detainees is not a function of his ministry.
“We do work with the prisons, and we try to give support where we can. The challenge with assuming control of inmates would clearly be that these are persons who are incarcerated because of particular breaches of the law, and the Ministry of Health is not a security arm. The Ministry of Health works in conjunction with the justice system and the security forces, and so we don't have the capacity — whether the training or orientation — to manage [those individuals],” he pointed out.
Dr Tufton, however, admitted that “more needs to be done”.
That “more” is what chair of the committee Justice Georgiana Fraser called for while speaking at the official unveiling of the report at the Supreme Court in downtown Kingston last week.
Justice Fraser, in pinpointing the myriad reasons the mentally disordered end up spending long periods of time in custody, said the paucity of psychiatric aides in the correctional services was critical.
She said that forensic psychiatric expert Dr Myo Kyaw Oo is the person in charge of Bellevue and is one of the individuals who has to review people in the correctional facilities. “So the resources are meagre. Our recommendation is that there should be more such persons,” Justice Fraser said.
Dr Oo is the only medical practitioner in Jamaica who is licensed to prepare forensic psychiatric reports. Further, there is no dedicated psychiatrist for the Department of Corrections, which only benefits from the services of less than a handful of sessional psychiatrists.
According to Dr Tufton, solving this issue “is a matter of expanding the establishment to have others permanently assigned to the particular task”, and that has been “a function of resources or funding”.
“We understand and appreciate the need for expanding the availability of staff across the board,” the minister said.
In the meantime, he said the issues raised by the committee were not foreign, pointing to the findings of the 2016 Task Force on Mental Health and Homelessness which was asked, among other things, to propose an implementation plan to foster a successful transition to a new Bellevue Hospital. The task force was also asked to make recommendations on the most appropriate payment structure for the Ministry of Health/Bellevue to finance a new infirmary and arrangements for shared overheads and proximate amenities. Additionally, it was asked to make recommendations on appropriate housing solutions for in-hospital homeless, outdoor homeless, and forensic psychiatric patients.