- Norman GrindleyAn elderly man sleeps at the Bellevue Hospital.
Klao Bell, Staff Reporter
MENTAL health officers (MHO) are the backbone of the community mental health programme, yet their work continues to be back breaking.
The present ratio of MHOs, to patients is a staggering average of one to 400.
There are only 35 officers caring for the population of approximately 16,000 mentally ill persons who depend on the public health system. Each parish, according to the Ministry of Health, has at least one MHO, few have two.
The shortage of officers is due in part to the fear of working with the mentally ill. But another reason is the global nursing shortage exacerbated in Jamaica by the emigration of local nurses to fill positions in North America and Europe. MHOs are registered nurses who are specially trained to Level Four.
But there has been some progress in the last five years as the number of officers has improved from 18 in 1997 to the present number, which increased over the past year. In 1998 there were 24, in 1999 there were 13 and in 2000 there were 19 officers.
Dr. Earl Wright, director of mental health services at the Ministry of Health, acknowledging that the situation is less than ideal, said, "We would like to have at least one mental health nurse per health centre but, right now, the ratio is one MHO to between 300-500 patients."
St. James, where the plight of mentally ill street people gained national attention when they were forcibly removed from the streets in 1999, had one MHO up to six months ago. St. Thomas has two officers while Kingston, St. Andrew and St. Catherine have eight officers caring for more than 4,000 mentally ill persons.
The task of caring for the mentally ill is mammoth by lay-man or professional standards, but it is dutifully carried out by a team of "highly motivated, committed officers""
"They like their jobs and do it well. They have a register and they know who the persons in their areas are," said Dr. Maureen Irons Morgan responding to the question of how the officers manage such a heavy caseload.
Dr. Irons Morgan who is the Regional Psychiatrist for the South-East Regional Health Authority which covers St. Thomas, St. Catherine, Kingston and St. Andrew, also admitted that, "we would like to have more officers so our ratio can be at least one officer to 200 patients."
"We're managing fairly well. We are motivated by a desire to see our clients well and we are willing to go the extra mile to see them get well. The reward is when six months later you're walking on the street and someone calls to you and say 'remember me, I'm back in my job now. Thanks for what you did'," said A. Leon Nooks, one of two MHOs in St. Thomas.
This, despite a caseload of 700 patients.
MHOs are required to visit the health centres in the parish, do house calls, conduct public health meetings and lectures, visit street people, attend church feeding programmes or other places where the mentally ill congregate and monitor and counsel family members of mentally ill persons - as well as write reports and other administrative tasks.
Iris Wilson, president of the Nursing Council of Jamaica said, MHOs, "should be better paid and better protected. They are sometimes attacked, abused and even chopped by mentally ill persons. They also need to be better compensated because they are called out of their homes twenty-four-seven."
MHOs are paid a gross salary of between $691,500 and $822,000 dollars annually.
