The dilemma of treating the mentally ill who are also destitute

Apr 13, 2021 Features / Columnists, Peeping Tom

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Kaieteur News – There are a great number of suspected mentally ill persons walking around the streets of the country. There are a great many others who are not mentally ill but simply destitute but who are treated as “mad” people.
Mental illness is a disease like any other illness. It afflicts the mind instead of the body but because the mind controls bodily functions and actions, an illness of the mind can have degenerative effects on the physical ability and constitution of mentally-ill patients.
There are treatments for mentally-ill patients, but these are often comprehensive and costly. As such, there has not been any significant attempt at addressing mental illness as a serious public health concern. Perhaps because there are more mentally ill persons off the streets than on the streets, it is assumed that the problem is under control. Another reason may be the difficulty in identifying from among the destitute just who are mentally ill and just who are only simply deprived and mimicking madness as a survival mechanism.
If it is tough off the streets, imagine how tougher it is on the streets for those who have to exist day-to-day, hand-to-mouth, without permanent shelter and often having to do relieve themselves in public.
As such there is need for a plan to address the growing numbers of destitute and the mentally ill persons on our streets. We should not wait until a major international event is held before taking steps to shelve these problems temporarily.
During 2007, the government in the haste to present a good face for the hosting of Cricket World Cup undertook a last minute effort to bus many destitute individuals into shelters. The public was assured that this would have been a continuous effort.
Today there are just as many, if not more destitute persons on our streets than there were in 2007, questioning just how effective and sustained has been the campaign to get dwellers off the streets and into a more comfortable environment where they will be less exposed to risk, can be given regular meals, a place to sleep and eventually reintegrated with their families and friends.
Then a few years ago there was a campaign to remove persons off the streets. It was even reported that some of the persons removed were placed in the mental hospital in Berbice.
Unfortunately, years ago one of those individuals escaped from that institution and drowned in one of the rivers in the area. This raised concerns not just about the institutionalising of persons but also about the security at the said institution.
It had long been reported in Guyana that the security at the mental hospital in the past had left much to be desired, since in the past, persons from that institution could have been seen regularly and unsupervised wandering all around a town in the area.
A number of questions therefore emerge. What are the procedures that are used to determine admission to a mental institution? And have persons been forcibly institutionalised in mental asylums in Guyana?
There has so far been no evidence that any illegal actions have taken place as regards the institutionalising of mentally ill persons within Guyana. But at the minimum, no person should be admitted to a mental home or institution without a medical referral from a competent professional.
Since a mentally ill person cannot be expected to make a rational decision to be admitted, the laws of most countries usually provide for that person to be institutionalised upon the recommendation of medical professionals. The situation is obviously compounded since a person cannot be assumed to be mentally ill, taken off the streets, seen by a doctor and then referred to a mental institution. If the person is taken to a hospital or clinic and is then seen by a doctor, then the person can lawfully be institutionalised.
But who takes the person to the hospital or clinic? If someone is forcibly taken away to be seen by a doctor, can that person be said to be unlawfully abducted?
If Guyana is to address the high incidence of destitute persons on its streets, it cannot do so without examining the laws and regulations pertaining to the institutionalisation of the mentally ill.
And for the simple reason that amongst the hundreds of destitute on our streets there are many mentally-ill persons, how these persons are going to be treated is another problem.
Then there is the financial concern. In a country in which there is competition for health resources, it is never going to be easy for governments to convince the public that more should be spent on the mentally ill.
In fact, if the average citizen knew just how much money is required to be spent to treat a mentally ill person back to good health, they would gasp at the sums and many perhaps would argue against such expenditure.
This is always unfortunate because mental illness is not incurable; most mental conditions are treatable and in fact if treated early allow for the patient to return to a normal existence.
Mental illness is also like any other illness and just as how great sums are going to be spent this year on dialysis, then perhaps some attention should be paid to the cause of the mentally ill.

(The views expressed in this article are those of the author and do not necessarily reflect the opinions of this newspaper.)

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