Judge: Mental health issues not taken seriously

A HIGH COURT judge has bemoaned that the stigma of mental health is not given the seriousness it deserves.

Making the observation was Justice Devindra Rampersad, who ordered a family to compensate a relative who claimed they conspired to have him admitted to the St Ann’s Psychiatric Hospital in 2016.

In his ruling, Rampersad said, “It is unfortunate that in today’s society, the stigma of mental health is not addressed with the seriousness that it ought. We still call the St Ann’s Psychiatric Hospital the ‘madhouse’ and we still call persons with mental health issues ‘mad’ or ‘crazy’ – putting unfortunate derogatory labels on a serious problem.

“It is hoped that the dignity and integrity of the person can be maintained and preserved by an independent monitor, as suggested, to safeguard the rights of those unfortunate persons who carry these unacceptable labels.”

He also suggested appointment of a mental health advocate to assist anyone detained under the Mental Health Act to ensure their rights and freedoms are not compromised.

As part of his ruling, the judge ordered the man’s relatives, who included his mother, two sisters and a brother, to pay him $15,000 in damages for the eight days he was detained.

“These defendants took the law into their own hands. There must have been an element of humiliation in being dragged from one’s bed in handcuffs and placed into an ambulance,” he ruled.

The North West Regional Health Authority (NWRHA), which has authority over the psychiatric hospital, was ordered to pay $150,000 jointly with the psychiatrist named in the lawsuit. After the trial, in September last year, the authority submitted to judgment, while the judge held the psychiatrist could not be held liable for the man’s admission to the psychiatric hospital.

However, he had some concern with the admission policy under the Mental Health Act for such cases, saying, “To my mind, it is a policy which causes some concern, since it opens the door for collaboration and possible collusion between medical practitioners.

“It seems to this court that the admitting practitioner under the MHA needs to be insulated from the certificate-issuing medical practitioner in order to dispassionately and objectively assess the very serious step of an urgent admission and the deprivation of a person’s constitutional rights and freedoms in respect of his/her liberty.”

In finding that the man’s admission and detention were unlawful, which had been accepted by the NWRHA, the judge said the deprivation of one’s liberty was a serious matter and, notwithstanding the concerns expressed, it was insufficient to deprive anyone of that liberty.

Rampersad said he accepted the principle in law that, except in emergency cases, a person cannot be deprived of his liberty unless it is reasonably believed they were in need of psychiatric treatment, but said in the case, neither the NWRHA nor the man’s relatives pointed to any statute or common-law principle to suggest they had the right or authority to do what they did.

“There was no crime committed or which was in the process of being committed, so there was no immediate danger for which some sort of citizen’s arrest could have been justified.

“There is no doubt that the claimant was arrested and detained without his consent. The evidence points to their decision that the claimant needed help for his mental illness and, without discussing it with him, chose to take it upon themselves to force that help upon him,” Rampersad said in his ruling.

He also said even if the man’s relatives were concerned for his mental health and their safety, “the answer could not be that they could forcibly arrest and remove him.

“An allegation of mental-health issues does not mean a suspension of the claimant’s constitutional and other fundamental rights. That suspension may be placed in the balance if there was an immediate need for some sort of urgent response. There was none in evidence,” he said, as he described the family’s actions as “clandestine.”

He also pointed out that the situation was exacerbated by the fact that the man, after he was detained, received no care or attention for his mental well-being, because the hospital staff were not aware of what to treat him for before he was eventually released without diagnosis.

In his post-script comments, Rampersad suggested the appointment of a mental health advocate in keeping with the “standard that one may expect from a State committed to the provisions of a written Constitution such as ours which guarantees certain basic rights and freedoms, including the freedom of thought and expression.”

In his lawsuit, the Port of Spain man, who claimed to be Jesus Christ, claimed he was wrongfully admitted to St Ann’s after he asked about his portion of the rent from a property he and his siblings shared in Santa Cruz.

At the trial, the man’s mother said the family was concerned about his “erratic” and “disturbing” behaviour.

The man was taken to St Ann’s on December 7, 2016, and was admitted for eight days. He was initially assessed as suffering from schizophrenia.