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A success story

judyThe journey to improve mental health care in St. Maarten

 

By Judy H. Fitzpatrick

 

What started over a decade ago as a government initiative to improve mental health care in St. Maarten has blossomed into a solid foundation fuelled by a dedicated team that is doing more to improve the lives of persons living with mental illness in St. Maarten.

 

But even as Mental Health Foundation (MHF) continues to expand its services and prepares to officially open the doors of its new home, which caters to more mental health clients, it still battles with growing stigma and discrimination in the community against the mentally ill. It is a challenge that the foundation is tackling head on with programmes to educate youngsters about mental illness in an effort to weed out stigma.

 

History

Provisions for mental health care in St. Maarten took off in 2000 when MHF was formed as a government initiative by then Health Sector Director Jorien Wuite (now Acting Secretary General of the Ministry of Health). The foundation was established to care for mentally challenged persons in St. Maarten, Saba and St. Eustatius. The foundation’s first board members were Elaine Gumbs Vlaun, Angela Dekker, Alpheaus Tatem, Dr. Lloyd Richardson, Ingelise Gerand and Saba representative Naomi Wilson.

 

Although formed in 2000, the start-up subsidy for MHF only kicked in, in 2006. At that time, the board had changed and was then overseen by Dr. Mike Mercuur, Richard Boyd, Cylred Richardson, Statia representative Aisheline Maduro, Saba representative Naomi Wilson and attorney Joeri Essed.

 

In May 2006, the first clinic for mental health patients opened at LB Scot Road #105. This was a significant step in caring for the mentally challenged. It was the first time that clients had a set location to visit a clinic in St. Maarten to see a psychiatrist. Curacao based Psychiatrist Dr. Montoya was contracted at the time to visit St. Maarten once a month for a week to see patients. Elena Reyes served as clinic nurse at that time. The service began to grow in popularity. Some 76 clients were under treatment in that year.

 

As is required in its bylaws, MHF’s board has since changed. Current board members are Dr. Felix Holiday, Fenna Arnell, Eric van der Hoek, Joeri Essed, Dr. Ruth Douglas (also United People (UP) Party Member of Parliament), Jimmy Challenger and Rogier Brands.

 

Client care

Today there are more than 400 patients and clients registered with MHF; however, the foundation believes that the number of persons in the community suffering from mental illness surpasses this figure.

 

Patients and clients are divided over the several care areas offered by the foundation. These include those who visit the clinic, those who receive psychiatric home health care, those who visit Faraja Center (at MHF’s new location in Cay Hill) for daily coaching in empowerment and re-socialization and those who use the crisis management facility.

 

There is also a group of clients who benefit from inpatient care and those who are involved in MHF’s recently introduced guided living programme. The foundation is also heavily involved in information, prevention and research.

 

The starting of MHF’s 24-hour in patient facility as of October means that mentally ill persons who are for whatever reason detained no longer have to be locked up in a prison cell or sent to Curacao’s mental facility as was customary in the past. Patients in St. Maarten can now receive proper psychiatric assistance and can be monitored 24 hours at the inpatient facility. “We no longer have to send clients to Capriles in Curaçao, which means they are closer to family and friends, which make them more involved in the treatment and development of their loved ones,” says MHF Director Eileen Healy.

 

Challenges

Growing the mental health care over the years was not easy. The challenges were many, but MHF’s first and current director, Healy, and her team never gave up and continued to forge ahead to achieve MHF’s goals. Challenges over the years included working with a limited budget, which has now increased, and coping in a small and inadequate facility to properly treat crisis patients and provide in patient care. MHF is run on an annual budget of NAf. 1,511,045 per year (2011 figures). Costs are met by consultations and contributions (subsidy from government and contribution from AVBZ chronic care health insurance). MHF is currently fuelled by 31 staffers.

 

Stigma

Stigma against mentally challenged persons remains a challenge for MHF. “Yes, there is still stigma in the community about mental health. This is due to the lack of understanding of mental health and the negative perception of what it is to be mentally ill,” said MHF Information and Prevention coordinator Danette Mc Rae-Gumbs.

“The stigma is expressed through discrimination when it comes to finding work, finding an apartment and creating new relationships. Mentally ill persons are often not treated as sick persons, but as persons who are a revolting and are intolerant. Recognizing the person has a problem is difficult but it’s possible.

“The best method would be to change the public’s view on the subject and speak to the younger ones, the students. MHF’s prevention and information team is actively out there visiting schools, addressing issues in the media, radio programmes, etc. So far Mental Health does receive great support from the community,” she added.

 

New facility

In November 2010, MHF got a new and bigger location when it purchased the old Sylvia Hotel building at Leopard Road # 1 in Cay Hill. The building was renovated and the foundation relocated in July and August. MHF is now preparing to officially open its doors following the visit of the Royal Family led by Her Majesty Queen Beatrix of the Netherlands.

 

At its new location, MHF continues to operate its five care areas at this location: Clinic Care (provides intakes, psychological/psychiatric evaluations and initial treatment for admission), Psychiatric Home Health Care (PHHC) (offers at-home treatment to patients/clients physically or mentally unable to leave their home), Faraja Center (daily coaching in empowerment and re- socialization), Crisis Management (assists in crisis situation through intervention and support), Prevention and Information (generates information from all care areas and directs it to the community through presentations, workshops, sessions and interviews).

The two new services now offered are Inpatient Care (provides care for clients who are in an immediate crisis and/or are in need of 24-hour observation and Guided Living (a re-socialization program in which clients having deficits in social and life skills would acquire the essential capabilities for functional independent living).

MHF sees its new home, its guided living and the in-patient care facility coupled with the quality services provided despite challenges over the years as its greatest successes. The official opening ceremony of the new building will be preceded by a visit from the Royal Family on November 3. Queen Beatrix will unveil MHF’s official plaque and tour the facility, meet with staff members and regular clients and receive gifts. The grand opening will be held in the evening hours with invited guests starting at 6:30pm. “Our fun wouldn’t end there. We will be having an open house the following day, November 4, where the community is welcomed to come in and get an hourly tour of the building starting at 9:00am. There is also going to be an open house party in the afternoon starting at 4:30 until 7:30pm,” said Mc Rae-Gumbs. “All are welcome.”

 

What clients say

How do clients feel about the care provided by the foundation? “MHF helps you to set up your life. It puts you in a better place and it keeps you going healthy every day,” said one client. “They teach you how to work among any people in any situation. It is important to St. Maarten because a lot of people can come and get their medication.”

Another client said: “It has given me stability and I look forward to coming to meet with friends and familiar people. MHF is my family. I love my doctors. They keep me doing what is right and staying focused. They helped me find a job to supply my needs. They show interest in us and our wellbeing. We can also talk to them. MHF helps to solve our problems. We don’t have to go to Curaçao; when you are sick, you can be [treated] here.”

 

Future goals

MHF’s future goals include working towards improving and growing its services. It is also working towards having a separate facility for its guided living programme and plans to focus more on job training and job opportunities for its clients. “We look forward to having students come in and do job training and work experiences with us. We currently have two former job training students now enrolled as staff members at our foundation. So we know of the deep impact this experience has on them. We also embrace having school sessions with students about mental health,” said Mc Rae-Gumbs.

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