Times of Malta, 19 February 2018
Clint Camilleri’s statement about the ‘Mount Carmel’ van paraded during the Nadur carnival was so wrong. Not only because it was in bad taste. And not only because he is the Parliamentary Secretary for Agriculture and Animal Rights, but even more so because it unfortunately reflects the state of policymaking in mental health. This is very wrong.
Let us put things into perspective. In Malta, mental health remains a social taboo, so much so that many people do not talk about it and some refuse assistance when it is clearly needed. But policymaking in the field does not help. How many of us, for example, know the difference and the respective importance of psychiatry and psychology? Is education about this reaching all levels of society?
Mount Carmel hospital is a monument to the failure in the field. It has been in a rotten state for many years and has often been used as a dumping ground for nepotism and incompetence. If truth is often stranger than fiction, Mount Carmel may be weirder than some total institutions depicted in novels and films.
The building is falling to pieces. It has recently witnessed escapes and suicide. Workers’ morale is at rock bottom. And it is now led by a chief executive whose only qualification is his loyalty to the party in government. As far as I know his other background, in banking, has nothing to do with mental health.
Well, judging by the government’s appointment of hundreds of loyalists in positions of trust, and judging by the sale of public hospitals and to land speculators, we needn’t be surprised. There is one exception in the area of mental health though: Commissioner John Cachia, whose voice is conspicuous by lack of government support. The exception really proves the rule.
Like so many aspects of the government’s deficit in governance, Mount Carmel qualifies for an independent investigation. Important questions need to be asked. For example, is risk management being carried out thoroughly? How is supervision of patients being managed and audited? Are tasks and roles being assigned according to expertise and competence or according to political criteria? What is being done about staff shortages? What remedies exist for patients and their loved ones in defence of their rights?
It is very sad that while mental health has gained increased attention in the media in the recent years, also thanks to some high-profile people who spoke about their own problems, the issue remains associated with stigma and deficit in governance. It also has to be made clear that when this matter grabs media attention, it is not always for the right reasons.
For example, when certain politicians declare their commitment to the cause, they are rarely taken to task about concrete decisions such as investment in the field, prioritisation by their respective political parties, and so forth. Opening up on an issue is plausible and brave, but this should be followed up by substantive legislation, policies and action.
It is imperative that policymakers are sensitised to research in the field and taken to task about it. Real journalism shouldn’t simply report on the previous job experiences of the new CEO at Mount Carmel: it should ask him concrete questions about mental health evidence, research and policy.
Similarly, raising awareness about mental health should not simply be about snackable and at times banal campaigns on television. Awareness should ensure that different people with different backgrounds are equipped to face the risks, services and challenges associated with mental health issues.
We should be thankful to selfless doctors, nurses and staff who do their utmost for mental health patients, especially when resources are so limited. But on the other hand, we cannot keep accepting a mental health system that looks more like a dystopian hellhole, devoid of basic services and facilities and which mortifies patients rather than empowering them to a better life.
I remain flabbergasted by the fact that those in charge of mental health are not being held accountable for their failures and how the government manages to camouflage the matter with bureaucratic talk and excuses. People with mental health problems deserve much better.
