Tabling the Annual Report on the Mental Health Commission for the year 2015

By Premier Hon. Alden McLaughlin, MBE, JP, MLA

April 2016

Madam Speaker, in accordance with Section 8 (a) of the Mental Health Commission Law, 2013, I am pleased today to place before this Honourable House the Annual Report of the Mental Health Commission for the calendar year 2015.

Madam Speaker, the Mental Health Commission was established in January 2014 under the Mental Health Commission Law, 2013. Madam Speaker, the members of the Mental Health Commission are as follows:

Dr Marc Lockhart                    Chair

Dr Taylor Burrowes                 Deputy Chair

Olivaire Watler                         Deputy Chair

Julene Banks                             Member

Kimberly Voaden                      Member

Faylene Ebanks-Suckoo          Member

Pastor Dale Forbes                   Member

Dr Enoka Richens                     Member

Vanessa Gilman                         Member

Madam Speaker, the members are stakeholders from various sectors representing legal, health care practitioners with training in mental health, and advocates/laypersons.

Madam Speaker, the functions of the Mental Health Commission are divided into three sections

The quasi-judicial section is set up to hear and determine appeals under various sections of the Law and conduct reviews where a patient has been detained and released under an emergency detention order three or more times in 30 days.

The recommendations to the Health Practice Commission and Councils section includes submitting an annual report to the Minister with responsibility for health, reviewing and advising on scopes of practice and codes of ethics for practitioners, providing policy advice to the relevant registering Councils and advising the Health Practice Commission regarding mental health facilities, medical research, and clinical trials in mental health.

The general functions section includes the following:

• Obtain and compile statistics on mental health
• Oversee and deliver mental health training for constables, prison officers and any other persons expected to deal with mental health patients in the performance of their functions
• Approve a list of overseas mental health facilities
• Research and establish protocols and guidelines for mental health advocacy and approve persons to act as advocates
• Establish and maintain a programme that provides information to the general public concerning mental illness and co-occurring disorders and related conditions
• Review the progress of patients transferred overseas
• Review every six months the progress of remand prisoners deemed unfit to plead and submit it to the Chief Officer, Judicial Administration
• Give policy advice to the Minister responsible for health on any aspect of the local mental health system

Madam Speaker, I will now speak to the contents of the report:

Mental health services are delivered through the Health Services Authority, local private facilities, and mental health care facilities located overseas.

The Behavioural Health and Psychiatric Unit, which was formerly Mental Health Unit, at the Health Services Authority is an eight bed unit that was designed as an adult facility for acute care of patients suffering from serious mental illnesses. There is also a facility providing treatment for patients suffering from alcohol and substance abuse, while Her Majesty’s Cayman Islands Prison Service accommodates mentally ill persons who have been incarcerated.

There is no inpatient facility for children and adolescents, but if necessary they are admitted to the unit, where they are treated. Madam Speaker, as stated in the first report of the Mental Health Commission last year, there is an adequate number of mental health practitioners employed in public and private sectors; however, the distribution of practitioners among the three Islands is disproportionate as there is no psychiatrist, psychologist or occupational therapist present on the Sister Islands. Madam Speaker, we are committed to improving our outpatient services so that the care that is needed is accessible in a timely manner to all.

Madam Speaker, as you may be aware in February 2015, Cabinet granted approval of the Policy Guidance for the development of a Long-Term Residential Mental Health Facility. This document outlines the broad policy direction to be followed by the steering committee, which was charged with the procurement process for the development of the facility.

Subsequently, the Strategic Outline Case was finalised and a request for proposals was advertised. Madam Speaker, the successful bidder was KPMG, which was awarded the contract in October 2015 to prepare an Outline Business Case for a proposed Long-Term Residential Mental Health Facility.

Madam Speaker, the training on the mental health legislation provided by the Mental Health Commission has been in high demand. Madam Speaker, you may recall that in 2014 the Mental Health Commission provided two training sessions; in 2015 Madam Speaker, the Mental Health Commission conducted six training sessions – to the Royal Cayman Islands Police Service, Department of Community Rehabilitation, Prison Services, staff of the Health Services Authority including members of the support group and the community, and the Department of Education Services allied health professionals/specialists teachers. Madam Speaker, training sessions will continue on a regular basis in 2016.

Madam Speaker, it is a requirement under the Mental Health Law, 2013, for all detention forms to be sent to the Secretary of the Mental Health Commission for storage and filing. The forms are reviewed by the secretary to determine whether the members of the Mental Health Commission need to be notified of any outstanding issues or observations. Madam Speaker, for the year 2015 there were 43 patients admitted for various types and degrees of mental illness, with over 75 detention forms received. During this period no request for an appeal was received by the Commission.

Madam Speaker, in order to assist the Royal Cayman Islands Police Service with understanding their roles and responsibilities under the mental health legislation, the Mental Health Commission developed a one page flyer that can be distributed among the three Islands. Madam Speaker, the flyer was officially hander over by the Chief Officer and the Chair of the Mental Health Commission to the Deputy Commissioner of Police.

Madam Speaker, in November 2015, the Chair of the Mental Health Commission presented at the annual health care conference on the topic “Bridging the Gap: The State of Mental Health in the Cayman Islands”. There were more than 700 participants in attendance. As well, a workshop was held focusing on “Mental health – Let’s talk about it”. Madam Speaker, the annual health care conference has helped to highlight the importance of mental illness and health within the community among friends, families and caregivers. It has given new meaning to mental health as people have become more knowledgeable, acceptable and tolerant to those persons who suffer from a mental illness.

Madam Speaker, the Ministry with technical and financial assistance provided by the Pan American Health Organization convened a stakeholder meeting for one and a half days to develop a National Mental Health Policy. Consultant Psychiatrist Professor Wendel Abel from Jamaica facilitated the meetings. The Ministry is awaiting the final draft of the policy.

Madam Speaker, other work of the Mental Health Commission during 2015 involved participation in World Mental Health Day activities celebrated each year on 10^th October; participation at the second Caribbean Regional Symposium on Suicide Prevention hosted in the Cayman Islands; collaborating with the Health Services Authority Ethics Committee to ensure that persons conducting research on mental health fulfill established criteria; and working with the Councils for Professions Allied with Medicine to develop scopes of practice for mental health practitioners registered under Councils for Professions Allied with Medicine.

Madam Speaker, before I take my seat I would like to acknowledge the work of Deputy Chair Dr. Taylor Burrowes who was accepted by the Caribbean Public Health Agency to present the findings of her doctoral research in a poster presentation at the annual scientific conference held in June 2015. I would like to congratulate her on being selected and to encourage her to continue to raise the awareness on mental health in the wider community.

Madam Speaker, in order to mitigate many of the problems in our society that we currently face, I believe we must facilitate early recognition and treatment of common mental illnesses by enhancing access to mental health care through an integrated approach. The Mental Health Commission will continue to educate, inform and empower those individuals who require our assistance.

Madam Speaker, we have a Mental Health Commission that is committed and has been working diligently since its formation, and the MHC continues to advocate and promote mental wellness for all in the community. We are one step closer since our last report in addressing the need for a long-term residential mental health facility for our chronically ill mental health patients.

Madam Speaker, in closing I would like to thank my Chief Officer and Ministry staff, and the members of the Mental Health Commission for their hard work, dedication and commitment to a subject that affects all of us. Indeed, the World Health Organization notes “there is no health without mental health”.

Thank you Madam Speaker.