If we want to live up to truly being "our brother’s keeper," the V.I. community has a lot of work to do. But, the work, though difficult and sometimes heartbreaking, is under way.
That was the message from a panel of mental health professionals who discussed mental illness—what it is, who can help, where to go, and how can we improve—in a forum Thursday sponsored by the UVI’s Center for Excellence in Developmental Disabilities (VIUCEDD) and Clear Blue Sky Clubhouse.
An audience of about 100—mostly health care professionals, victims’ advocates, and parents—listened intently, later peppering the panel with questions.
Psychiatrist Leighmin J. Lu said about 6 percent of the territory’s population is receiving or is in need of mental health care. About 3,000 persons go through the system annually, he said.
According to Lu, the World Health Organization defines mental health as a "state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community."
Broadly speaking, mental illness can be characterized by impairment of an individual’s normal cognitive, emotional, or behavioral functioning, caused by social, psychological, biochemical, genetic, or other factors, such as infection or head trauma," Lu said.
VIPD Sgt. Maria Colon-Jones, Zone C Commander, discussed the department’s responsibilities in dealing with the mentally ill. "It’s not easy," she said. "We are the first responders…. We can’t just take the person away from the home because the family asks us. They just want the person ‘out.’ The person has rights; the family must have documentation. It’s complicated.
"People are sometimes violent," Colon-Jones added, "but we use tasers, batons or handcuffs. We use deadly force only as a last resort."
Colon-Jones addressed a question frequently put to the police regarding the homeless. "You can’t simply pick up someone on the street because he is homeless,” she said. “The person has rights; he has to be proven to be a danger to himself or others."
That same criteria apply to admission to the Schneider Regional Medical Center (SRMC) Behavioral Health Unit.
SRMC psychologist Dr. Lori Thompson and unit director Leoneilda Blake described the hospital’s short-term care services, which are designed to treat the patient no longer than 10 days, when the patient should be able to function on his own, or be referred to a long-term care facility.
Registered Nurse Jacqueline Davis of the Barbel Outpatient Clinic sees about 40 patients a day, with a staff of 12. None of the territory’s facilities—the Barbel Clinic or the Eldra Schultebrandt Long-Term Care facility on St. Thomas, the Morris de Castro Clinic on St. John, and the Christiansted and Frederiksted Mental Health Clinics on St. Croix—have a resident psychiatrist.
Attorney Archie Jennings of the Disability Rights Center says the most pressing need in the territory’s mental health care programs are psychiatrists.
Jennings knows whereof he speaks, with 28 years of patient rights advocacy under his belt. Jennings said his agency, a not-for-profit private patient advocacy group, is the only one in the Caribbean.
Jennings said the center has formed a seven-member commission to formulate a five-year strategic plan to address mental health problems.
"Under Commissioner Liston Davis," Jennings said, "we’re moving. We will circulate the plan with the hospital corporations, the Legislature, the Supreme Court of the V.I. for comment when it’s completed."
He said, "We’re looking at the lack of a psychiatrist in the territory. It’s not a good sign when we have no psychiatrist at Juan Luis Hospital. It’s a setback…. The mental health system has deteriorated because of neglect. We have committed mental health practitioners trying to hold it together, but they carry a great burden. We are trying to do the best with decreasing funding."
All of the forum participants agreed on two pressing needs: a mental health crisis emergency room and a detox facility, where the patient is treated for substance abuse.
Mark Genovesio of the Village Virgin Islands on St. Croix said the facility has treated the homeless, mentally ill, and substance abuse patients for 20 years. "Housing is critical for aftercare. The challenges are phenomenal. When we discharge a patient, where are they to go?"
He said the Village is working on a halfway house facility that he hopes will be ready this summer.
Guest speaker Evan Gerrard, of the International Center for Clubhouse Development, said the program offers an identity. "People with a mental illness don’t belong. They have nowhere to go," he said. "Our program empowers them. We offer a place to come where they are always welcome, where they have duties, where they will be respected. We have a work program where we place members in a job that the clubhouse sponsors."
Arlene Monaghan, Clear Blue Sky Clubhouse executive director, and board secretary Luz Moron spoke of the local program. "The members are guaranteed a right to a place to come, to meaningful work, to meaningful relationships, and a right to a place to return," Monaghan stressed.
"Everyone is equal," she said. "Staff and members work together every day. It’s a community of men and women of all ages, who come together to assist each other. We don’t offer counseling. We put people to work so they gain self-esteem."
Moron presented a slide show of a typical day at the clubhouse, providing an illuminating look at just how the operation works. Another insight was provided by two clubhouse members who spoke movingly of their experiences. Both lauded the feeling of belonging the clubhouse gives them. One said, "It gives me a place to come to, to learn to be respectful, to learn values. And I have a job."
In other words, both have something to fill their day, a place to come where they are welcomed, have duties, are respected, kept busy, and where they learn something.
After a question-and-answer session, VIUCEDD Assistant Director Carl Cole suggested future follow-up forums to ensure that progress continues.