30 Jan Girl Interrupted
MENTAL HEALTH STILL CARRIES A STIGMA, AND THE MERE MENTION OF MOUNT CARMEL HOSPITAL CAN STILL TRIGGER IMAGES OF PATIENTS IN STRAIT-JACKETS, TEARING THEIR HAIR OUT AND SCREAMING THEIR HEADS OFF.
IMAGINING CHILDREN IN THOSE WARDS IS EVEN MORE DISTURBING, BUT SOME KIDS DO END UP IN ITS YOUNG PEOPLE’S UNIT. ALISON BEZZINA PEEPS IN TO FIND OUT MORE ABOUT THEIR PARTICULAR NEEDS… AND THE PARTICULAR CARE THEY ARE BEING PROVIDED.
Last August, a 12 year-old girl, who was receiving psychiatric care at Mount Carmel Hospital, was charged with making hundreds of illegal calls to the emergency line and threatening officers. At the time,
she was being kept in an adult ward, where, it was said, she was being insulted and threatened by other residents. The court recommended to the hospital management to immediately transfer the girl to the children’s ward.
Needless to say, when it comes to kids and youths with psychological problems, the situation is even more delicate because it is universally acknowledged that their needs are different from those of adults; they require a different set of skills from the staff, a different environment, and sometimes, a completely different approach.
One indisputable truth is that mental health issues still carry a deep, dark stigma, and that, as wrong as it is, the mere mention of Mount Carmel Hospital triggers images of patients in strait-jackets, men tearing their hair out, and women screaming their heads off – images that, with today’s medical and therapeutic advances, should no longer exist.
Another truth is that about 10 to 15 per cent of the world’s child population suffers from mental health problems. Generally, the incidence is twice as much in children living in industrialised areas, and is higher among boys than girls.
But these figures are only the tip of the iceberg, and digging further down the statistical line, gets even more worrying. So what actually goes on behind those closed doors? And are the mental images, perpetuated by the movies, just fiction?
The Young People’s Unit at Mount Carmel, first set up in 1992 handles clients with a variety of mental health problems some come in with conduct disorders, resulting in bullying, or truancy; others have emotional disorders, such as anxiety and severe insecurity. But the most serious cases are those suffering from psychosis, or bipolar disorders, and rarely, they may be paranoid and suffer from hallucinations.
Youths are usually referred to the unit from the Child Guidance Clinic at St. Luke’s Hospital. Very rarely, in acute cases, they are also admitted as an emergency measure, says the YPU nursing officer Marion Saliba. “The unit is not meant to be a permanent residential home and admitting clients under the age of 12 is always a very last resort,” she insists.
At any one time, the unit can only accommodate up to four girls and four boys, aged between 12 and 16 But since the YPU is the only Child and Adolescent Psychiatric In-Patient Unit available on the island, unfortunately, there have been times when children under 12 have had to be admitted, she says.
“Since the aim is to reintegrate them in society, all users must have a community outlet as part of their therapy. Sometimes, however, the environment and the background they come from are inadequate and unstable. In such cases, it is not possible for them to return to their families, and once their therapy is over, an alternative placement has to be found for them.
“Sadly, however, there are a few clients, who, due to their very difficult and problematic behaviour, cannot readily be resettled in society, and in the absence of appropriate community residential units, they require long-term hospitalisation as the only available solution.”
Try to forget about the films… The building of the YPU was originally the residence of one of the consultants taking care of the patients, so it looks more like a home than a medical ward. Although it is old and always in need of upkeep, the patients enjoy the luxury of a TV room, an office, two bedrooms – one for the boys and one for the girls – a dining room, a pantry, a relaxation room, and two bathrooms.
“A few years ago, we also set up an occupational therapy room and a classroom furnished with computers, while our most recent project was the relaxation room, with special equipment to help the youths relax,” explains Ms Saliba, who is responsible for the YPU’s daily management, including liaising with the parents and other agencies.
The courtyard is big enough for them to play ball, or ride a bicycle, and leads to a large garden, a specially designed play area, a BBQ, and two pet corners, currently housing birds, mountain goats and a dog.
“It is important that during their time at the unit, clients live as normal a life as possible,” Ms Saliba insists. “So during a typical day, our youths wake up, make their beds, get dressed and have their breakfast. Some go to their regular school, while others attend the YPU class, which is run by a teacher and a learning support assistant.”
Between 8 a.m. and 2p.m., they follow the same routine they would at a school, with similar break times and lessons. After school, they are helped with their homework, followed by some free time to watch TV, or play.
They also attend occupational and psychotherapy sessions, and from time to time, they are also taken out on recreational and social activities, organised by the staff. In the evening, they shower and prepare for their parental and guardian visits, and after dinner, they have more time for games and TV before going to bed at around 9 p.m.
But despite the efforts to create an environment that is as distant from a mental hospital as possible, Ms Saliba acknowledges that Mount Carmel is still stigmatised. “The real issue lies with how people perceive mental health. Such disorders manifest themselves in behavioural changes, so the person ends up suffering not only from the symptoms of the condition, but also faces serious difficulties in being accepted as part of the community.
“It is a pity that society holds such prejudices when it comes to mental disorders,” Ms Saliba sighs. “The brain is just like any other organ in the body. It can get temporarily unwell, or suffer from a chronic illness that will always need care. It’s no different from having a lung, or a liver condition, except that if left untreated, the symptoms manifest themselves in the person’s behaviour.”
Unlike fully grown adults, adolescents also have to deal with the usual problems that a growing child comes across, especially during puberty, Ms Saliba highlights. Only close family members and guardians are allowed to visit the youths at the unit, and though this may sound strange, there’s a good reason for it.
“Close family members and guardians can visit the clients four days a week for a restricted number of hours. This is because the youths need time away from their environment and families to be better observed by professionals,” Ms Saliba explains.
“While away from their normal environments, they also get time to think and evaluate their behaviour, and are helped to identify and talk about their problems, while behaviour modification can be implemented.”
The success of treatment, which could involve medication and a host of therapeutic approaches, depends on the physical, psychological and emotional development of the youth, as well as the gravity and nature of the mental health problem, Ms Saliba continues.
In most cases, the treatment given at the YPU is considered successful. The majority of patients return home to their families and manage to integrate back into the community. In some cases, however, just like with other physical disorders and conditions, they must return to Mount Carmel and the YPU for follow-up treatments and support.
Most families are very caring and protective over their children, notwithstanding their mental problems, according to Dr Joseph Saliba, acting chairperson of the department of psychiatry at Mount Carmel and the consultant in charge of its YPU, responsible for the mental health welfare of the youths in its care.
However, he adds, a minority are uncaring, or neglectful, and this may contribute to both the initial causation and perpetuation of the problem. Others become so exhausted by their situation that they are temporarily – and even permanently – rejecting.
A Helping Hand
YPU is a safe haven for youngsters in dire need of help. From time to time, various NGOs have lent a hand to upgrade the facilities and improve the environment. However, it is always in need of equipment and financial support. For donations, send an e-mail to gouder5@yahoo.co.uk.
Children too suffer from mental illness, require help and a homely atmosphere. These are the issues the Ladies’ Circle Malta has been working to raise awareness about. Founded three decades ago, the club for females from 18 to 45, has offered a number of services, including a project for the Young Persons Unit at Mount Carmel Hospital. Wanting to add that little touch to make a difference in the lives of these children, who are in the unit through no fault of their own, it donated curtains and bedspreads for the bedrooms, toys, DVDs, kitchen utensils and other required items. “They are children like any othersand have their needs – particularly not to be ostracised and to feel part of society,” the club points out. “Visiting the home was an amazing experience –the staff works so hard to create a homely atmosphere,” it said, auguring that the public could be more tolerant and appreciate others’ suffering.
For more information on Ladies’ Circle Malta, contact its president
Kathleen Flynn on 9983 6199; or send an e-mail to flynnikins@gmail.com
www.ladiescircle.org
First Published on Pink Magazine – Jan 2011
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