Consultant claims hospital discriminates against drug users
Maltese hospitals discriminate against drug abusers in terms of the care they are given, according to a consultant psychiatrist.
Anthony Dimech, a consultant addiction psychiatrist at Mount Carmel Hospital, works with psychiatric patients who have a drug use problem and finds it “very difficult” to have patients admitted to certain wards when they need it.
“When these people have to be admitted to hospital because of psychiatric problems – even severe ones – they are discriminated against, because they are not admitted into the ward where they can be treated in the most appropriate environment,” Dr Dimech complained.
He raised the issue during a conference on addictions, held by the Malta Association of Psychiatric Nurses. Drug users are not allowed in the mixed admission unit at Mount Carmel Hospital or the short stay psychiatric unit at Mater Dei Hospital, while in other wards only a very limited number of substance abuse patients are allowed, according to Dr Dimech.
While in Mount Carmel there was a dual diagnosis unit, which specifically dealt with psychiatric patients with a drug problem, the unit had only eight beds and was often full, he said.
This number, Dr Dimech said, was not enough, particularly because “it is estimated that 50 per cent of those with severe mental illness have at least one substance use problem.”
“The way our mental health services are designed does not address the fact that substance use disorders are on the rise,” he said, adding that however, those with a bad drinking problem are still admitted into these wards – “and rightly so”.
Even though patients with drug use problems were still treated, their opportunity of care in the right environment was not equal to the rest, he added.
Putting a depressed person in a seclusion ward, which was one of the wards drug users could be admitted to, could actually be detrimental to his situation.
“I am still waiting for the first individual to sue the hospital for this discriminatory practice,” Dr Dimech said, adding there had also been cases where nurses threatened industrial action if they had drug addicts on their wards.
Reacting, an association representative said it endorsed the stand taken by nurses, as “heroin addicts should not be nursed in wards where dementia patients are being treated... if patients are reviewed more often, there would be more space for different kinds of patients,” the nurse said. Another nurse said: “We can’t just look at patients from the medical point of view... we have to provide a safe environment for our staff.”
Dr Dimech agreed, but said that assuming beforehand that a drug addict would be more dangerous was discriminatory and stigmatising, and patients should be treated as dangerous only when there was a history of dangerous behaviour.
“It is no secret Malta has a drug problem that is similar to other western countries. Mental health and addiction services should reflect this reality”.
When contacted for a reaction, the Health Ministry said it was not in a position to reply.
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Charles Sammut
Nov 27th 2010, 21:16
Drug related diseases, psychiatric or otherwise, are self inflicted. Just like lung cancer in smokers and chirrosis of the liver in alcholics.
It is about time that responsible people stop supporting irresponsible ones. It only exacerbates the problem by encouraging more of the same. And quit invoking Christianity. Christians believe that if they die in mortal sin they go to Hell - for all eternity, no ifs and no buts.
Manuel Mangani
Nov 28th 2010, 16:35
Mr. Sammut, you proffer a very simplistic view of addiction. In many cases psychological/psychiatric conditions are present before the substance abuse starts, which indeed can be an attempt at self-medication of poorly-understood feelings and states. Even when psychiatric conditions are a result of addiction, the very fact that there is severe dependence renders the individuals incapable of helping themselves without proper assistance.
Obviously, unconditional acceptance and unfettered access to unlimited assistance will not be of help to addicts, who must be encouraged (or coerced, even) into taking whatever responsibility they can muster. expecting severely addicted persons (with concomitant psychiatric conditions to boot) to help themselves on their own is totally unrealistic - and inhumane.
Lewis Balzan
Nov 27th 2010, 11:26
Jien ma niskantax b'din id-diskriminazzjoni. L-isptar ilu snin kbar jiddiskrimina ma nies li mhux midhla tal-ministri u tal-membri parlamentari tal-Gvern. Kulhadd jaf li min hu ta' gewwa jirnexxilu jaqbez il-kju u jinqeda malajr aktar. Sfortunatament min mhux ta' gewwa (jew m'ghandux xi qaddis) irid joqghod jistenna u jinkazza jara n-nies jiehdu servizz qablu. Dik ghalija diskriminazzjoni sfaccata.
C Mangion
Nov 27th 2010, 14:36
Igifiri inti qed tghid li kull min jinqeda go l-isptar joqod icempel lill ministri min qabel biex jaqbez il kju? Nahseb ghandhom iktar x'jaghmlu il ministri!!! Jekk tmur fil privat ukoll issib min jaqbez il kju u min jinqeda qablek.. u gieli fil privat ikollok tistenna sieghat ukoll. Laqwa li meta tkun stennejt tiehu servizz tajjeb, u nista nassigurak li servizz tajjeb hemm jistenna n nies tal kkju
David Gatt
Nov 27th 2010, 11:09
How should we treat drug addicts? Like heroes?
We are throwing millions of euros every year to keep these people getting their legal fix when we could be investing this money on much more needed sectors, like cancer treatment for example.
I'm not saying we shouldn't help these people, but I believe that help should be strictly limited only to those who really want to walk out of their problem.
A Cassar
Nov 27th 2010, 17:22
Dear David,
besides the lack of human or Christian compassion, your lack of understanding of the subject is amazing.
Drug addiction is classified as a DISEASE, just like cancers, heart disease, pneumonias etc etc. The fact that drugs being illegal, and thus these individuals resort to crime to feed their habit, makes them no less a human. For many other diseases you can also blame the patient, heart disease and cancers secondary to smoking, diabetes to over eating, hypertension due to salt intake, liver failure due to alcohol. We probably gain MORE by spending our money on "drug addicts" because unlike with other diseases...it is not just the patient and family which suffers, but all society with them. Money spent on drug addicts makes Malta a safer and healthier place!
C Mangion
Nov 27th 2010, 18:18
finally someone who speaks sense! Proset A Cassar. At least someone has a compassionate streak left in themselves.
Charles Zammit
Nov 27th 2010, 10:58
“patients should be treated as dangerous only when there was a history of dangerous behaviour.”
Does this mean that there has to be a precedent before taking the precautionary measures? Is this really the logical approach to guarantee the safety of other patients?
Manuel Mangani
Nov 27th 2010, 11:41
No, it does not mean that "that there has to be a precedent before taking the precautionary measures". Precautionary measures should be (and often are) a matter of routine. The point is whether those precautionary measures should include the assumption that ALL drug users will pose a danger to other patients, and therefore refuse admission in certain wards to all drug addicts, as opposed to addressing the problem on a case-by-case basis.
One cannot but agree with the psychiatric nurses that patient and staff safety is paramount . But the right to treatment in the best facilities available is (or should be) sacrosanct.
Jeremy Lanfranco
Nov 27th 2010, 14:04
Anybody could be a danger to other patients and staff irrespective of whether they suffer from drug addiction, are special needs clients or psychiatric clients. As a matter of fact and with 28yrs working in hospital, most trouble makers are normal clients with a hot temper.