What drives a mental patient mad? That is the question everyone is asking after last weekend's brutal butchering of two teenage sisters by a crazed and mentally ill Ryan Elston Horne. Horne's family says and we have confirmed that Horne is indeed a mental patient, but instead of a mental hospital the accused killer is with the general population at the Hattieville prison. There is also the case of Daron Zuniga, another mental patient, who was shot and killed after he fought with officers on a Hudson Street rooftop. All this brings back into sharp focus the care or some cases the lack thereof for our mentally ill. Today we found that while the politicians talk, those on the frontline are working but towards what solution, that's what we tried to find out.
Keith Swift Reporting,
On December 23rd of 1999 Prime Minister Rt. Hon. Said Musa and the then Minister of Health Jose Coye promised residents of the Rockview Mental Hospital that it would be their final Christmas at that facility.
Rt. Hon. Said Musa,
[December 23rd, 1999] "We will do better for you. We know for instance that when it rains a lot behind here you have a lot of problems so our government is working on a program to build a new facility, a new mental health facility that will bring about improvement, a better life, and a better quality of life for all of you. We are hoping to make a start on that project in the new year."
Musa alongside Health minister Coye sliced cake for the residents in December of '99 and four years later on February 27th of 2003 he along with the same Minister of Health Joe Coye broke ground at the KHMH for a new mental health center. In December of 2003 Musa was back again at Rockview to share the Christmas cheer. This time there was caroling and again that promise of a new facility.
Rt. Hon. Said Musa,
[December 2003] "Next year we are going to start construction of this new mental health hospital in Belmopan, we going to live in the capital now, so when we have lotta rain and floods we don't have to worry."
But after all those promises there is still no new mental hospital and three mental heath related deaths this past weekend. Jennifer Bowman says at least two of those deaths could have been prevented if this accused killer, Ryan Elston Horne, was at Rockview.
Jennifer Bowman, Horne's Aunt
People will look at it and say it's a vicious murder, because I saw everything that went on, I watched the two young ladies down there and it is nothing nice to see and my heart bleeds to see two persons down there. I don't know what to say because if the system was up to mark, this wouldn't have happened. You have to pay money to be at Rockview and that's not really nice because I think they should have somewhere to take those people."
But Kathy Esquivel from the Mental Health Association says Rockview isn't the solution or the problem.
Kathy Esquivel - Secretary Mental Health Assoc.
"There were two very unfortunate incidents and our hearts go out to especially to the mothers of the two girls who were killed but the natural reaction is, I heard people want to lock up everybody and that is not the solution. Most people will mental illnesses are not a danger to anyone else, in fact they suffer more danger from other people often."
So if Rockview isn't the answer then what is? Well experts in this field say
part of the solution lies at Mental Health Outpatient Clinics such as this one at the Port Loyola Health Center.
Dra. Claudina Cayetano, Psychiatrist
"Psychiatry is part of medicine so if you are in a crisis and you need hospitalization, you get into a hospital. So if you are not in a crisis, just like you have cough and cold, you can come and see the doctor and go home so we have what we call a outpatient clinics. So here right where we are, we are at the outpatient clinic which people walk in and come for treatment and we also have what we call mobile clinics where nurses will go and look for patients in their home. So the mental health program is a comprehensive approach."
Nurse Eleanor Bennett and Augustina Eligio are on the frontline of the struggle to manage Belize's mental health problem. They are called psychiatric nurse practitioners and there are only 22 of them in the country. They each see about a dozen mental health patients a day.
Nurse Augstina Eligio,
"We are psychiatric nurses, we are like in the forefront. We do assessment of patients, we treat, we see patients in the hospital at KHMH, at home, in the streets, at prison, at Sister Cecilia Home, Golden Haven, Belize River Valley, the cayes, and the list goes on and on. We deal with people who we need to maintain their mental health as well as we deal with patients who have for some reason become mentally ill."
But there is still only so much that nurses like Eligio and Bennett can do,
only so much advocates like Esquivel can do, and only so much that Belize's only two trained physiatrists can do. They say ultimately a mad killer like Ryan Elston Horne can only be stopped by his family.
Dr. Roy Lopez, Psychiatrist
"Patients have to be medicated and we require that families follow the guidelines when we discharge patients from the hospital. They have to come to the clinic and some times a patient cannot come by himself and he needs support from the family so that's very very vital."
Kathy Esquivel,
"Families are the people who know what's happening with their relative that have a mental health problem and when they see changes, when they see things that they are not happy with, I would encourage them to go and see the psychiatric nurse practitioner or the mental health practitioner so that some follow-up can be done. And so even though, I am not saying families can deal with it themselves, but when they see something that looks like its not right, I wouldn't suggest they go to the police because the police are not trained to deal with it but there is a mental health service, go and check with them and somebody might be able to help them before incidents like this occur."
Dra. Claudina Cayetano,
"We have to understand that psychiatric patients are very difficult to manage so we know that as professionals because sometimes patients don't have the incite into the illness to say 'I need the treatment, I am hearing voices, and this is not normal, so I need to go and get my injection.' They won't say that and that is why we need the family to follow up. I want to, when it comes to this particular case, I think its a right opportunity to perhaps empathize with the family of the deceased, its very sad, our condolences to them. I know this is very difficult for people."
The mental health facility at the Belmopan Hospital can only hold four patients while Rockview has a capacity of 52 patients. It is at that capacity presently. Rockview is also voluntary and patients cannot be forced to stay there. Patients are charged a dollar a day but it is not mandatory. All medication dispensed by the psychiatric nurse practitioners is for free or for a nominal costs. Visits with doctors Claudina Cayetano and Roy Lopez are also free.
