Rockview patients need public/family support

It was World Mental Health Day on Sunday, but while the day is intended to increase public awareness of mental disorders, for most Belizeans mental health remains an abstract concept. At least, until you “buk up” to someone on the street who is talking or singing to him or herself or even taking off their clothes in public. Then the encounter becomes uncomfortable to say the least, and if the person acts in an aggressive manner you may even become afraid. Your first thought is “Why isn’t this person at Rockview?” News Five visited the much criticized Rockview Hospital to find out why there seems to be an open door policy at the facility and what is being done to deal with Belize’s mentally ill.

It’s been twenty years since the Seaview Hospital, was moved to mile twenty-one and a half on the Western Highway and dubbed Rockview. But not many changes have taken place within the hospital for the mentally ill. The institution remains isolated from the community; there are not enough beds, sometimes not even enough food for the fifty-five patients. Although there has been an increase in staff and the introduction of programs and activities, the buildings continue to deteriorate. Nurse Augustina Elijio, was recently appointed as the new supervisor of Rockview Hospital. Elijio says there are a number of changes she plans to implement.

Nurse Augustina Elijio, New Supervisor, Rockview

“Physically we need some changes. The buildings are in a deplorable state; they are in need of renovating. We need to be working with the staff, some new staff who have very little insight into how to deal with the mentally ill. So I plan to do a lot of training with these personnel.”

While the staff struggles with the day to day limitations on their resources, the public is most concerned about the fact that the patients often wander off the compound.

Nurse Augustina Elijio

“Security, physical wise is not there. We have no barricades; there is no fence. So patients do escape now and then but we have more staff at this point in time and they are like extra eyes watching out so they should not be escaping as fast as they used to but they do escape.”

Jacqueline Woods

“The problem has also spilled onto the streets of Belize City. Belizeans and tourists alike are either harassed or witness embarrassing moments. They say it is high time that something is done to address the situation.”

Woman #1

“One of them was out here naked. One of them was walking around on the Twenty First (Independence Day) naked begging the boys who were buying hotdogs.”

Woman #2

“Yesterday I was waiting to catch my bus and I saw two of these women just walking on the street and I was thinking how come something isn’t being done to help these people.”

Man

“Should have an institution where they can get whatever they need, like their food or clothing. Organizations like the church to assist them – that they should be inside of an institution and not on the streets.”

Dr. Claudina Cayetano says it is important for the public to think of the patients as individuals who unfortunately suffer from mental illness. She says the mentally ill should not be locked away in an institution as if they are criminals, but treated as human beings and given the best care possible. She is working on a comprehensive plan to upgrade the psychiatric health facilities in Belize. It will include closing Rockview and expanding mental health centers and the treatment given to patients countrywide.

Dr. Claudina Cayetano, Psychiatrist, Ministry of Health

“We don’t think of them as nuisance and just lock them up. And it is not only medication; it’s a service that comes from the community, from family support, from the doctors, the nurses – it is comprehensive. People should not feel like once they have a mental illness they should be punished for that cause if you have a physical illness you are not punished.”

Ann Gordon, Twenty-three Years Old

“People on the streets, they treat me like I am a stranger, like I am somebody who does not belong here.”

Twenty-three year old Ann Gordon was recently released from Rockview. Today she wanders the city streets with her boyfriend who is also a mental patient. Gordon, who says she has no family to support her, sleeps on the streets.

Q: “You mind your own business or do you go out and harass people?”

Ann Gordon

“Sometimes I am very ignorant. I am ignorant. I go and do things that I don’t remember that I do it when I am doing it or when I start doing it.”

Q: “Is that when you are not on your medication?”

Ann Gordon

“Yes.”

Q: “How often do you receive your medication?”

Ann Gordon

“My medication. I don’t study the list; the list I don’t keep it up for myself.”

Because patients like Gordon become troublesome or even violent when they don’t take their medication, the psychiatric clinic has initiated a mobile service. A nurse and a social worker patrol the streets looking for patients who have become delinquent in their treatment. But not everyone who wanders the streets is mentally ill.

Nurse Augustina Elijio

“What we need to look at is, there are a lot of homeless out there; there are a lot of people taking drugs out there who are not really psychotic. They are not really mentally ill so we need to be very careful when we label the type of people we see out there.”

Besides the outreach program, there will also be in house programs. Rachel Bull, a member of Voluntary Services Overseas, is an occupational therapist assigned to the Ministry of Health. She is developing a program of activities to help the mentally ill become self-sufficient.

Rachel Bull, Occupational Therapist

“If you visit Rockview you find that a lot of patients are wandering around, they have nothing to do. They are not being prepared to return home where they can take up a useful place in society.”

Eventually, under the new plan Rockview will be replaced by a psychiatric home in Belmopan. The shelter is intended to decrease homelessness among the mentally ill and improve their living conditions. It should also help decrease the relapses triggered by stressful situations. However, Dr. Cayetano says it will take the will of the community and the people’s support to make the program work.

Q: “How involved is the community?”

Dr. Claudina Cayetano

“The community is very involved in criticizing Rockview. The community is very involved in looking at all the negative aspects that Rockview has. We are not denying that there are things that shouldn’t be there but I would like more people to be active in terms of providing more community support.”

Nurse Augustina Elijio

“Family support is a big deal for us. There are a lot of families that whenever patients are admitted they don’t want them back in society; they don’t want to be responsible for them.”

Until it is replaced by something better, Rockview will remain the primary care center for Belize’s mentally ill. The staff says all Belizeans can assist them, not only by donating items the hospital needs but also by calling the psychiatric clinic if they see a disorderly individual they suspect is a mental patient.