A regular Source column, Undercurrents explores issues, ideas and events developing beneath the surface in the Virgin Islands community.
It’s hard to get a community to focus on an issue that people don’t even want to see.
A class action suit didn’t make it happen. A consent decree didn’t make it happen. Years of meetings between advocates and government officials didn’t make it happen. A comprehensive report by a hired consultant urging a system overhaul didn’t make it happen.
Now some people are taking another approach: urging people with mental illness and their families to speak up for themselves.
“We’re trying to build self-advocacy to keep the focus on the government” and get it to implement the upgrades the consultant recommended, said Archie Jennings, an advocacy attorney with the Disability Rights Center of the Virgin Islands and a leader in the years-long campaign to upgrade mental health and substance abuse care in the territory.
Thursday a nationally recognized mental health expert will speak with – and to – V.I. mental health care providers, consumers, their families, and anyone else who is interested in improving a system widely viewed as inadequate.
“The first step is having mental health consumers and their families involved,” said Chacku Mathai, who has worked in the field for 30 years and who, he says, has had his own issues with mental illness. “The phrase is ‘Nothing about us, without us.’”
Mathai will speak at 6 p.m. Thursday at the Disability Rights Center offices in Havensight Mall, above the Deli Deck restaurant. All are welcome; admission is free.
“Clearly there’s a lot of need in the U.S. Virgin Islands,” said Mathai, who is the director of one of five STAR Centers operating under the auspices of the federal Substance Abuse and Mental Health Services Administration.
SAMHSA provides funding to the Virgin Islands for mental health services and is taking an active role in trying to bring the territory up to standard.
Mathai’s center serves nine states and territories in two regions. He was asked to identify three for priority and proposed the Virgin Islands as one of the three. The Virgin Islands is in Region 2 which also includes Puerto Rico, New York and New Jersey. His center’s other region, No. 6, covers Oklahoma, Arkansas, Louisiana, New Mexico and Texas.
Compared with other states and territories, Mathai said, “The Virgin Islands doesn’t have much of a community voice. It has the beginnings of it but more is needed.”
This is the first year of the five-year SAMSHA grant and Mathai’s second visit to the territory. In April, he met with government and private sector leaders on St. Croix, including representatives of the Virgin Islands Health Department, AARP (the American Association of Retired Persons) NAMI (the National Alliance on Mental Illness) and groups dealing with domestic violence.
Mathai is familiar with the consultant’s comprehensive Five Year Plan for overhauling psychiatric services in the territory. The draft was released in 2013; it was itself an outcome of a class action suit brought 10 years before that by the Disability Rights Center and other local non-profit organizations in an attempt to force the V.I. government to improve mental health and substance abuse services.
“There’s a lot of good things that are in it,” he said.
One of those is the recommendation to focus on integrating individuals into the community rather than isolating them in institutions, he said. Another is stressing the importance of early intervention.
The report also concluded that raising public awareness and removing the stigma attached to mental illness are vital to coping with it. Among a myriad of other conclusions and recommendations, it urged privatizing at least a portion of services, leaving the government’s Health Department in the role of overseeing services, and creating a forensic unit in the territory to handle severe cases. (See links below for more on the Five Year Plan.)
The report said the government would save some money if it eliminated widespread duplication of services, but clearly implementing all the recommendations would be very costly.
“I do see the frustration” over delay in putting the plan in place, Mathai said. “I share in the sense of urgency.” However, it will take people to make it happen.
It’s difficult to document the number of people who suffer from mental illness. National estimates are as high as 25 percent of the population, but that includes a wide range of disorders and temporary as well as permanent conditions. When the Source published a series about the territory’s mental health care services in late 2013, the director of Mental Health said there were almost 1,000 people receiving regular out-patient services in the territory at government clinics. There were scores more in residential facilities, in the territory and stateside, many housed with the Bureau of Corrections – and an untold number who were not receiving treatment at all.