Mental healthcare has seen significant developments over the last century. At the beginning of the last century, the gold standard of mental healthcare was based on “moral treatment”, essentially meaning treating people with mental health needs as people.

This treatment was aimed at improving the social skills and self-worth of patients. This approach was gentle and compassionate. But it was also expensive and labour-intensive.

From the middle of the last century, with the development of new antipsychotics, an era of de-institutionalisation saw many mental hospitals closing down. Mental healthcare was transferred from institutions to community health centres that catered for psychiatric outpatient treatment.

While the number of patients in Mount Carmel Hospital fell dramatically, the standards of care also fell. This psychiatric hospital is characterised by neglectful facilities that are poorly managed and that have shown little signs of improvement in the last several decades.

During the current energy crisis, Mount Carmel psychiatric patients were left in the dark and heat for more than four hours on one night when the hospital’s generators failed to kick-start during a power cut. While the hospital has a series of generators servicing some wards, they could not work when the power went off.

Some patients were screaming, panicking, and shouting. Nurses had to use their mobile phone torches to walk around. The health and safety of patients and hospital staff were unnecessarily put at risk because of the hospital’s management failure in their duty of care for those under their responsibility.

The history of de-institutionalisation of mental healthcare is complex and filled with good intentions and poor results. Mount Carmel Hospital has long been in the headlines for its rundown state, with many healthcare professionals and relatives of patients describing the facilities as inhumane and disgraceful.

In 2018, Health Minister Chris Fearne promised that a new health hospital adjacent to the Mater Dei Hospital would be up and running by 2025. There is little or no evidence of progress in turning this promise into reality.

There is one underlying theme in all these inadequacies – the government’s unwillingness to spend the money necessary to cater for the needs of mentally ill people. The attention span of the administration on improving the health system is short. The health authorities react to incidents like the power outage with new promises. They make no systemic change to promote a vision of mental healthcare that is gentle and compassionate.

Society must express solidarity with the medical professionals who have to work in the grim environment of Mount Carmel. In 2018, the National Audit Office report on the state of the psychiatric hospital highlighted shortcomings in practically every aspect of its operations, saying it is underfunded and poorly staffed, with poor relations between management and staff, and inadequate security.

While some progress has been reported, the hospital facilities remain poor and unsatisfactory.

As long as there has been illness, there has been mental illness. And as long as there has been mental illness, there has been problematic treatment of mental illness. The gross inadequacies of our mental health system must be addressed.

The public health system is failing psychiatric patients. More human and financial resources are needed to ensure that Mount Carmel Hospital and the psychiatric healthcare in the community give patients the highest level of care they deserve.