Farewell to a pilgrim
July 19, 2019
WHAT NOW, West Indies?
July 19, 2019

Many mentally ill on the streets

One of the many homeless persons on the streets of Port of Spain.

Story by Kaelanne Jordan,
Email: mediarelations.camsel@abpos.org – Twitter: @kaelanne1

The question of how to care for a non-compliant loved one with a mental illness is “a very important question” as mental illness is one reason why family members abandon their loved ones on the streets “because they don’t know what else to do”.

This according to Mental Health Consultant Carl Ryan, while responding to a question during the Q&A segment of his presentation, ‘Mental Health and relationships in the home’ May 21. The talk was hosted by the St Charles Borromeo RC’s Ministry of Consolation.

St Ann’s Psychiatric Hospital, which was built over 100 years ago, is the only psychiatric hospital in Trinidad and has a capacity for under 2,000 persons.

“So where the others…they on the streets… so we have a serious problem,” he said.

Ryan further compared the local Mental Health Act which is under 40 pages long to England’s Code of Practice for Mental Health, 400 pages. To this end, he emphasised that the mental health fraternity ought to “market” themselves.

“People don’t know what to do when in fact there are things you can do but the service is very poor.”

The Mental Health Act No 30 of 1975 allows psychiatrists to treat patients who consent to treatment and those who don’t consent. Ryan explained, “So the Mental Health Act allows us to force treatment on a non-compliant patient because at the time they need the treatment they’re not going to rationalise the benefit of their treatment. So we act as their advocates.”

Ryan also addressed the stigma and pride of going to the “mad house”. He however maintained, “But your family life comes first….” He advised those seeking advice on how to care for a loved one with mental health issues to visit their nearest health centre and speak to a mental health officer.

Ryan highlighted when a patient is refusing treatment then certain “documents” have to be written up by two doctors. Then the police are summoned.

Ryan said once the person is refusing treatment the psychiatrist will require support. He however maintained that he usually avoids summoning the police because “police are not trained…and police officers are human beings and as they tell me ‘We fraid mad people and we don’t make joke with them’.”

Ryan warned that if the non-compliant patient’s situation is getting worse and they are at risk of harming themselves or others, these are the two main reasons for admission to hospital.

Sadness or Depression?

There was active participation during the Q&A with persons from all walks of life sharing—young, old and a youth with mental health disorder. One female participant who experienced three deaths in a year asked Ryan to distinguish the difference between sadness and depression. She shared that a relative thought she was experiencing depression.

Ryan explained that depression may not necessarily be a display of emotional symptoms such as stripping oneself or drinking and talking “nonsense”. If however, persons are able to cope with their stressful situation and go about their normal daily duties without it affecting their normal function, “then that’s okay,” he said.

Ryan further explained that sadness is a deep sense of loss that could continue for a period of time. “You don’t need medication for that; you need a supportive network of friends and family,” he said.

On the other hand, with depression “try getting out of a car with your seat belt on and see how far you get. Try to get out your bed with an elephant on top of you, that is what depression is,” he said.

He gave this advice to persons in similar situations: “If you still walking around with that bag of stones, what I suggest ever so often you take one stone out the bag and throw it away.”