With little or no comment, persons with mental illnesses are being fed into our badly overcrowded prison system and health authorities appear to be making no attempt to correct this situation.

FOR DE RECORD BWOur jails were never intended to serve as treatment facilities but persons with mental disorders and substance abuse problems continue to be placed behind bars, where they can be dangers both to others and to themselves.

Mental health officials in both the public and private sector can testify to the fact that prison is not an optimal setting for persons with mental disorders. And despite reforms to focus on rehabilitation, it is easy to determine from a look at the structure of our correctional system that it is not offering any satisfactory care to mental health patients. Nonetheless, the criminal justice system, as currently designed, continues to ship mentally-ill persons to jails, which are serving as de facto mental health facilities.

In July, the fate of Sherwin Hyle should have triggered a conversation and, more importantly, action by the state to adequately process cases involving persons like him who are mentally ill.

Hyle, a prisoner on remand who was deemed to be of “unsound mind,” was sentenced to 15 years imprisonment for fatally stabbing another man. He was being tried for a second time for killing Joel Savory at Friendship, East Bank Demerara in 2008. He had pleaded guilty to the lesser count of manslaughter. As expected in these cases, a probation report was read in court before he was sentenced and it disclosed that he was struggling with a mental disorder and would constantly wander the streets naked.

Government psychiatrist Dr Bhiro Harry, this country’s leading mental health specialist, was called to testify in the case and he said that Hyle was suffering from schizophrenia and he would experience hallucinations. According to Harry, Hyle was unfit to plead to the indictment. However, his expert testimony was discarded by the jury, which decided that Hyle was fit to plead.

I read this and was just stunned. How could a jury throw out a competency report from a specialist in the field? What qualified members of that jury to determine Hyle had no mental disorder and was fit to stand trial?

What is also troubling is the silence on the situation, particularly from care providers, who ought to be advocating for the Health Ministry to develop and implement appropriate programmes for individuals struggling with mental illnesses that may lead to violent behaviour or criminal conduct.

In the absence of any local pronouncements, I turned to other jurisdictions and stumbled upon discussions coming out of California, which is grappling with its own failures to treat mentally ill prisoners, having allowed many of them to pass through the criminal-justice system without any intervention.

Based on those discussions, if a defendant knew the role of each person in a courtroom—prosecutor, defence attorney, judge—and understood his/her right to a jury trial, the defendant was considered competent to stand trial.

However, this is not conclusive. As some experts have pointed out, if you repeatedly put these questions to a person, even if they are mentally ill, at some point they are likely to get it right by the sheer repetition of going over the questions with them.

The key question is actually whether the defendant who is deemed mentally ill can assist in his/her own defence and understand the consequences of his/her plea. With respect to the Hyle case, Dr Harry submitted that the patient was not fit to assist in his own defence.

Hyle is just one of several mentally ill patients who require treatment and not punishment but are being sent to prison anyway. Two weeks after Hyle was sentenced, Otis McCurdy, 21, appeared in a lower court and was sentenced to six months in prison after admitting that he threw a large brick through a Church’s Chicken glass door. He claimed he was thirsty. The investigating rank in the case, however, informed the magistrate that McCurdy was of unsound mind.

To be clear, my concerns about what is happening with mentally ill patients in the criminal justice system is not meant to overlook the fact that justice must also be served. Persons who break the law and cause harm should face the legal consequences of their actions. But are we punishing people for being sick? And what of the danger that mentally ill persons can pose in the prison system, of which we have unquestionable evidence? One of the more well known cases is that of former policeman Solomon Blackman, who had a long history of mental illness. In 2004, he killed two policemen and wounded two others after an episode at the Brickdam Police Station. Later, in 2010, while he was an inmate at the Camp Street Prison, Blackman incited a disturbance which led to his death and that of another prisoner, Dyal Singh.

For years, we have been told that the Health Ministry is not turning its back on the mentally ill yet there is no existing national mental health programme in the country and not for some time. I know because I called the Ministry of Health during a two month period and followed up with visits but came up empty.

Even worse, the ministry’s staff seemed shocked that I was even asking about mental health. The responses included, “We got a mental health programme still?” and “How long ago that was…? Try Georgetown Hospital” as well as more callous dismissals like, “Look, ask Bhiro Harry.” Based on what I encountered, I concluded that the services at Dr Harry’s clinic are the programme, full stop.

It’s time to reform our health care system so that mental health is prioritised in the same way that chronic and communicable diseases are. I am fully aware that the health care system is constantly under much financial stress but there is also a lot of wastage in the system.

In addition, according to our laws, the Home Affairs Minister has the authority to move a prisoner of unsound mind to a mental hospital, where he/she is to be kept and treated until a medical superintendent certifies that that prisoner no longer needs treatment at that institution. This intervention ought to be made much earlier and the Home Affairs Minister could take the lead in advocating for a study of alternatives to incarceration for mentally ill patients and which must also focus on early intervention and treatment services.

At the very least, we need to ensure that the mentally ill gain access to the help and services they need and a good place to start would be with the recognition that they aren’t available in a prison cell.

 

Have a question or comment? Connect with Iana Seales at about.me/iseales

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