A woman has described the “disgusting” state of the seclusion ward at Mount Carmel mental health hospital after she spent about 10 days in a “cell” with nothing but a thin mattress to sleep on and a squat toilet with no flushing.

The woman, who took photos of the bare cell, said she was kept in the seclusion ward because she had tested positive for coronavirus.

Sources familiar with the psychiatric hospital confirmed the photos are genuine and that the ward was repurposed to host COVID-positive patients.

The woman, who is bipolar and preferred not to be named, explained that at the end of November she was admitted to Mater Dei Hospital for health reasons. At around the same time, her mother passed away.

She tested positive for COVID-19 and after a few days at Mater Dei was asked to transfer to the state-run Mount Carmel due to fears she would “do something stupid” following her mother’s death. It was not her first stay at Mount Carmel.

Once there, she was kept at the seclusion ward since she needed to be isolated.

Cannot flush toilet from cell

“The ward is one big room and next to it there are three cells. I call them ‘cells’ not ‘rooms’ since they have bars in the windows,” the woman told Times of Malta.

“You are locked in at night or when someone new is admitted.”

She said her cell was about 12 by 10 feet, with a squat toilet “when I was suffering from vomiting and diarrhoea. It was disgusting”.

She could not even flush the toilet from the cell – she had to bang on the glass behind the bars for someone from outside to do so.

“It was hell. All I had was a mattress which was about two inches thick… I was there for about 10 days. I had nothing to do. I was only allowed to keep my Kindle. They took my phone which they gave me on the last day, which was when I took the photos.

“They came to my room twice a day in full protective gear to give me my medication. That was all the human contact I had.

“This environment is not conducive to good mental health… when you have mental health issues you don’t want to be able to ruminate,” she said.

Patients unable to follow recommendations 

Asked for comment, a Health Ministry spokesperson said the seclusion ward is used in line with the provisions of the Mental Health Act and according to established protocols and policies governing restrictive care.

Patients admitted to a mental health facility undergo a risk assessment and are placed in a ward according to their care needs, the ministry said. Those who have tested positive for COVID-19 need to be placed in the “appropriate ward” taking into consideration their mental state and infectivity.

“Although the aesthetics of such a ward may not be appealing, one needs to appreciate that COVID positive patients who are unable to follow public health recommendations due to their mental state present a challenge to the containment of the spread of infection, thus the need to use such a restrictive setting.

To this end, the ward is equipped with a ventilation system to decrease the risk of infection, the spokesperson said.

The seclusion unit is made up of secure bedrooms that have a bed, a Turkish toilet and a window leading to an observation corridor.

The ministry said patients with COVID-19 infection are placed there for a number of reasons, such as if they are being unmanageable or presenting a danger to others, have a history of violence or have suicidal behaviour which cannot be contained solely with Level 1 supervision.

When the patient’s behaviour improves and the risk of harm is reduced, they may use the common TV area and are free to use the bathroom and shower.

However, the Maltese Association of Psychiatry is not impressed by the conditions: “We all deserve to live in the comfort [of knowing] that if we or our loved ones needed in-hospital mental health care, we would receive it in a safe, dignified place with the best standards in place.

That is why the association continues to advocate for better standards of care across our mental health services.

The association also stressed the need for transition to community-based services that offer alternatives to in-patient care. 

“Mental illness deserves no less than any other physical illness,” it said.

Earlier this month, a 20-year-old Dutch woman wrote of her eight-day experience at the hospital.

“It was hell,” said Belle de Jong, describing communal showering reminiscent of German concentration camps, dirty and depressing common areas, a chaotic distribution of medication, lack of fresh air and being stripped naked for a drug check.

Concern about the state of the Attard hospital has made headlines over recent years and most of its ceilings were condemned by architects in 2019.

The government is planning to build a new mental health hospital, near Mater Dei hospital, by 2025.