Editorial: During Mental Health Awareness Month We Should Reflect Why We Lack Adequate Care

During Mental Health Awareness Month, Virgin Islanders might look inward and explore practices by our government agencies that may be insensitive and counterproductive to helping those who need care or dispelling the stigma of mental illness.

In the last few months, four Virgin Islanders have died by suicide, according to the V.I. Health Department, highlighting the scant, archaic and non-existent mental health services available in the territory.

While there are private mental health providers, the V.I. Government ultimately has not done its job to protect its residents.

We should examine and be open to correcting outdated practices and providing better emotional health support to save lives of victims and ease the pain of families and friends.

According to a mental health provider for the territory, the “biggest deficit” in the system is not having an inpatient unit on St. Croix.

“Every doctor is putting their license at risk because there is no psychiatric unit when someone needs inpatient care,” she said.

Several recent cases underscore the extreme results of inadequate treatment and empathy, whether due to the lack of resources, ignorance or apathy in the Health and Education Departments. (The people who spoke with Source did so with the promise of anonymity).

In 2012, St. Croix’s Juan F. Luis Hospital closed its mental health ward without much explanation. Since then, the hospital has designated a room or two in the hospital to confine a patient. That doesn’t help patients who need a 72-hours hold or more to prevent them from hurting themselves or others.

Before it closed, a young man who “knew when he wasn’t feeling right,” said his mother, checked himself into the St. Croix psychiatric ward when he needed help. Then he would function normally for about four months before he needed the services again, she said.

In 2013, this young man and eventually his mother moved to the mainland, where they were able to find the emergency mental health services he needed. After he passed away in 2018, the mother moved back to the territory.

“I know of 80-year-old mothers caring for 50-year-old sons. What’s going to happen when they die,” she said.

Another chance to heal occurred at the JFL hospital last October when a middle-aged man checked himself in, asking for help with depression and suicidal ideation. Because he tested positive for COVID, he was shut in a closet in the emergency room with a sink and a bucket.

The psychiatrist saw him once briefly and prescribed a Benadryl. The family was told they couldn’t call the doctor and she wouldn’t see them unless they showed up at 5 a.m. in the ER in case she showed up. The nurses and doctors likewise told the family they could not do anything for him unless ordered by the psychiatrist and they were ordered not to call her. The man’s private therapist was told also she could not speak to the physician. The man walked out of the hospital the next day-his depression deepened by the experience. Almost exactly two months later, he died by suicide.

The insensitivity and unprofessionalism were not only apparent in the hospital on St. Croix but the St. Thomas hospitals and the V.I. Department of Education also showed a lack of empathy and mental health training.

A former educator on St. Thomas experienced hellish treatment on that island after she had a breakdown in 2019, partly due to being overmedicated. She was admitted to the psychiatric ward at Schneider Regional Medical Center, where she remained for a week. Her medications were regulated, but there was no counseling or therapy.

“It wasn’t a great experience. It was very uncomfortable. Except that I was in a safe place where I couldn’t kill myself. That was the only good thing,” she said.

Adding insult to injury, upon returning to work at her school, she was treated with suspicion – watched in the classroom – and ostracized by coworkers.

After two years of being “iced out” in the workplace, depression again took over and she took family leave. Since it was during the COVID pandemic, she attended online therapy sessions to ease her symptoms.

None of the staff or administrators checked on her nor offered the support employees usually extend to a sick co-worker – not a casserole or a get-well card, despite stellar reviews and being promoted to the administrative staff.

“I didn’t feel safe going back. The only option was to resign.”

Recently, the woman had another episode and chose to stay home, sedated by her physician, rather than return to SRMC.

The new, temporary hospital on St. Croix – JFL North – did not designate a ward but has two small, windowless rooms for psychiatric patients. According to the hospital’s public information officer, the new hospital will be built with a mental health ward – but that’s five to ten years away. In the meantime, people with depression and other emotional issues suffer and die.

St. Thomas is a little more accommodating – they still have a ward and recently opened a clinic in the hospital for mental health care.

There is currently one psychiatrist on St. Thomas and one on St. Croix. The St. Croix psychiatrist is responsible for the hospital, the community and the prison. One physician is not acceptable, especially since the work appears to be overwhelming her, so much that she can’t treat patients sufficiently or counsel their families.