Migrants with mental health issues should be treated at detention centres rather than at Mount Carmel Hospital, according to the CEO of Mental Health Services.
“I believe we should provide mental health services in the detention centres themselves. Nowadays we offer medical care in our premises at Mount Carmel Hospital but I believe we should offer the treatment at source.
“This will make sure no one is left out. I fear there are cases that we are missing at the detention centre, even considering that mental health is taboo in several cultures apart from Malta,” Clifton Grima told Times of Malta.
Dr Grima, who has occupied the CEO role since October of last year, was contacted after the publication of a damning Jesuit Refugee Service report which described the conditions at the hospital as being so bad for migrants that many of them being treated there ask to be sent back into detention.
I fear there are cases that we are missing at the detention centre
Focusing on the 74 migrants who were under inpatient psychiatric care at some point during their detention period between December 2013 and June 2014, the report was presented by JRS psychologist Julian Caruana,
This newspaper asked the Health Parliamentary Secretary permission to visit the hospital’s Asylum Seekers Unit but two days after the launch of the report, access has still not been granted.
Dr Caruana said the JRS understood the security issues but the emphasis should not be just on safety.
“There should be less restriction on movement as at times patients were let out of their room only for an hour. There should also be an overhaul of the ward,” he said, adding that patients should at least have basic amenities like a bedside table as in other wards.
Dr Caruana, who has visited the unit himself to speak to patients, noted there was not even a room to speak in private.
The report, presented on Tuesday, describes the unit as “completely substandard”, with small rooms equipped with only a bed and a toilet bowl. The flushing can only be activated from outside the cell.
Dr Grima explained that this was a safety precaution so that patients do not use the flushing chain to strangle themselves. In fact the report noted that most migrants with mental health problems are only admitted for treatment at Mount Carmel Hospital after trying to commit suicide within detention.
The JRS report also says that the vast majority could not speak English but a third of them had no access to interpreters or communicated through fellow detainees.
However, Dr Grima said yesterday that since July, the hospital had started providing cultural mediators through the Refugee Commission, which also sends interpreters, because Maltese doctors sometimes found it difficult to speak to patients.
Also, since May, female inmates with substance abuse started being housed in a separate ward. This did not mean there was never an overspill because of the ward’s limits, he added.
This point was highlighted in the report which noted that the ward can only cater for 10 patients but sometimes also accommodated Maltese female inmates with substance abuse issues.
Meanwhile, the JRS report says patients are only allowed out of their room for around an hour a day.
This was not true nowadays, Dr Grima said, adding that on the contrary, the hospital insisted that the cells’ doors were kept open as much as possible.
“Following the launch of the Mental Health Care in October, the hospital has tried to leave the cells’ doors open as much as possible and access to yards is granted upon the consultants’ recommendations.
“A compromise has to be reached whenever there are patients of different ethnic races and the time they are allowed to spend outside their room has to be split among them,” he added.
Dr Grima said he will be discussing the JRS report with other entities, including JRS itself.
Parliamentary Secretary Chris Fearne will be meeting JRS over the report next week.