A woman with autism has described how she has no choice but to spend her nights at Mount Carmel Hospital, where she shares a ward with a man awaiting trial for murder and a self-proclaimed rapist.

The 31-year-old holds down a full-time job during the day but every evening she returns to the psychiatric health facility because there are no residential services that cater for people like her.

Her diagnosis is autism and behavioural problems.

She is among a group of people who stay at the hospital despite not having severe mental health problems. Sharing her story with Times of Malta, she asked to use the pseudonym Gaby* to protect her identity from her employer, who does not know where she lives.

“I work full-time. I can function. But I need some support,” she said. “The mentality is that we are crazy here, and they just chuck anybody in without considering their needs, probably because there is no other place for some of us to go,” she says.

After a troubled childhood, Gaby moved out of her family home at the age of 15.

“I wanted to get away from my family abuse, so I tried to commit suicide. Since then, I’ve been bouncing around various places... Most recently, about seven months ago, I was dumped back at Mount Carmel because I was told I am a difficult person to have around due to my autism. With no specific residential service to cater for my needs, it was either at Mount Carmel or the streets,” she says.

The mentality is that we are crazy here, and they just chuck anybody in without considering their needs, probably because there is no other place for some of us to go- Gaby*

People who work in the field of psychiatry have long been talking about a gap in the system – with no place to handle adults who have behavioural problems.

With no place to go, some of these cases end up at Mount Carmel Hospital, living with patients deemed of similar risk. The government has pledged to close down the hospital – but the question remains about the future of such people.

Unlike the patients, who cannot leave the hospital, Gaby goes out to work each day, leaves the hospital by 7am and returns by about 3pm in summer, and 6pm in winter.

But the hospital has rules.

‘I have no freedom’

“I have no freedom. They have a routine, and I have to abide by it. So, they dictate what time I shower, eat and sleep,” she says.

“If I’m tired after work and want to go lie down on my bed, I am not allowed. If I miss dinner, which is served at 5pm, I don’t get to eat. The showers are open at 7.30am so I can’t shower before work.” 

While she is grateful to the nurses at the hospital, she thinks the system is broken.

Apart from the fact that the system does not cater for people like her, she believes it is making her condition worse.

She is aware she cannot live completely alone since she needs emotional support. “I struggle to control my emotions due to my autism. Which means that, if I am feeling down, I need someone to speak to, to calm me down and make me put things into context,” she said, appealing for supported living in the community.

“People see me – a woman who works and functions – and think I am fine. But there is a big crack. I want to live with dignity and respect. I work and pay taxes. I try to go to work every day as this is my duty. But I expect society to respect me. I want a home in society,” she says.

A woman with autism pulls at a pillow as she appeals for a suitable place to live.

Not a one-off case

Valerie Brincat, an occupational therapist who spoke on behalf of the Autism Parents Association, said Gaby’s case was not an isolated one.

“Mount Carmel Hospital is not autism friendly. We have patients even younger than Gaby, who were admitted there and got worse.” The association has raised the issue with the authorities. 

Better support services would help avoid unsuitable hospital admissions and improve the overall well-being of people with autism and their families.

Recommendations include community-based, specialised housing with staff trained in autism who can provide emotional and practical support.

Questions were sent to the Health Ministry asking about several of the claims made by Gaby, including the routine imposed on non-patients, the mix of people in wards, and the way forward for cases like Gaby’s.

A spokesperson said: “We do not think it is appropriate to comment on individual cases, but we can confirm that at Mount Carmel Hospital there are a number of individuals who do not require a mental health hospital anymore.”

*Not her real name