The national spotlight has once again turned on Mount Carmel after a teenage patient managed to escape the mental hospital through a bathroom window, travel to Buġibba and died by suicide at a hotel. Now a person who until recently was employed at Mount Carmel has spoken to Lovin Malta about one of Malta’s dirtiest secrets.
This is his testimony:
Photo: The bathroom window at Mount Carmel which the teenage boy broke out of last weekend
Today is the 4th of February. A Sunday. I woke up to the news that a young man who had absconded from Mount Carmel Hospital the day before has now been found. Dead. I am numb; I struggle with initial confusion and disbelief, then sorrow and disappointment, and finally anger –and yet, I did not know this man. I am outraged that the very institution charged with a responsibility to protect this man had failed him.
I am writing this after having read reports of this tragic loss by various news agencies. I am not writing this to add some juicy or morbid details, but rather to shed some much needed light on what goes on in our healthcare systems and how something as dreadful as this might have happened, with the somewhat naive hope of it never happening again.
A principle aim of psychiatry may be said to be identification of risk of an individual to themselves, and to others. Indeed, some consider risk management and reduction to be the priority of such care. Following identification of high risk of harm, a level of supervision is prescribed in the interest of patient safety. In those exhibiting a high risk, the so-called “Level 1” supervision is assigned; this entails very close supervision of an individual at all times by a suitably trained health professional, in order to identify, raise alarm to, and prevent harmful actions (one might also consider this in itself to be a deterrent to harm).
Due to staff shortages and managerial issues, the required number of staff to accommodate requests for higher level supervision across the hospital is not always met. This ultimately leaves prescribed patient care being unfulfilled, to the evident detriment of the patient.
In such circumstances, patients deemed to be at high risk of harm receive suboptimal and to a degree substandard care. It is only without this supervision that a young man, who was not supervised to the level prescribed by the medical team, was able to smash a wooden window frame off the bathroom wall and abscond.
Overworking of staff and undersupplying of resources may have likely contributed to these awful events – perhaps the concurrent storm provided cover against which blows to the window frame could not be heard, a la The Shawshank Redemption? Perhaps said storm discouraged any visitors/staff members/patients from strolling through the gardens when this escape occurred and witnessing events as they unfolded? Perhaps. But one cannot deny that these could at most be secondary factors, compounding the horrendous state of the infrastructure at MCH – a bundle of poorly thought-out buildings which prove hazardous in themselves, fittings of which had deteriorated to such a state that they could be forcibly removed without attracting attention.
Needless to say, some blame the doctors, nurses, ward staff. I may be somewhat biased, but I would not assign fault to these professionals; the vast majority merely try to perform their roles to the best of their abilities, given the very limited resources available. Instead, I feel that if there is any blame to be had, it’s to be far wider-reaching than that.
It is the stunning passivity of our society and the frank refusal to move with the times that is essentially responsible – why, in 2018, must we banish our psychiatric patients to a crumbling decrepit asylum, devoid of basic safety devises such as smoke alarms? Why must mental illness be treated and nursed in isolation, far from patients with more physical complaints? Why are psychiatric services so grossly underfunded, and staff so under-supported?
One might argue that this is simply a symptom of a bigger issue; that of mental health awareness and appropriate fund allocation. One might well be right. The conditions of our outdated and Victorian asylum do leave a lot to be desired.
The tragedy here lies not only in the loss of a young man’s life, but in the loss of trust in our health services – one would have expected a psychiatric hospital to be the safest and best place for somebody afflicted with a mental disorder to be. Some might say that this was evidently not the case.
Moving forward after such a catastrophic incident may be difficult for some, and easier for others. But this must not simply become just another news article to earn sympathy messages for those so sadly affected. Instead, action must be taken to prevent a recurrence of this heart-breaking situation - mental health funding must be addressed, and more appropriate resource allocation considered if we are to change circumstances for the better.
We must illuminate depression and indeed all mental ailments, remove the dreadful stigma associated with them, and treat mental health as we would all other maladies; with dignity and respect.
We must not let this happen again.