The Queen’s Gambit was all the rage last year. A TV series set in 1950s Kentucky, about Beth, an orphan, who strikes up an unusual friendship with gruff Mr Shaibel, the kind-hearted janitor who goes on to teach her how to play chess in the orphanage basement. The game becomes both addictive and protective. But it was really Beth’s other addiction to the green and white ‘vitamin pills’, doled out indiscriminately (and abusively) by the same orphanage, that really intrigued me. It had me frantically googling ‘orphanages + tranquillisers + 1950s’ for weeks after.
The pill in question bears a striking resemblance to chlordiazepoxide, otherwise known as Librium, which was certified in 1960 as a cure for both anxiety and insomnia. Prescribing such drugs was once common practice, as, indeed, were orphanages administering intravenous sedatives. This, of course, should come as a surprise but I’m afraid it doesn’t. It’s uncomfortably reminiscent of the way some institutions, the world over, operate to this day, routinely over-prescribing, treating patients high-handedly and stripping them of choice and dignity.
At the risk of being accused of peddling dangerous stereotypes, I think we can all agree that, in far too many respects, our own Mount Carmel Hospital falls short of expectations. It is not an idyllic psychiatric unit, an oasis of calm that allows patients to work through mental issues, achieve stability and rejoin society.
The first time I wrote about it was back in February 2018, following a report by the Commissioner for Mental Health, John Cachia, drawing attention to the physical state of various wards and calling for their immediate improvement. In that article, I applauded the commissioner’s forthrightness and made the point that the first step towards recovery and wellness was to provide patients with a decent residential environment.
Patients, I argued, could not receive optimal care in a building that was itself neglected and crying out for structural maintenance and aesthetic improvement. The 150-year-old building had clearly seen better days and was now inadequate and unsafe. I advocated a “seven-year road map” and implored the government to look deeply into its conscience (and pockets) and make Mount Carmel a priority, giving it the attention it so desperately deserved.
A year later, following an interview given by psychiatrist Anton Grech, the Maltese Association of Psychiatry (MAP) confirmed that Mount Carmel was not only unsafe and dilapidated but also unfit to treat patients. It supported plans for phasing it out and replacing it with a new psychiatric hospital conducive to the delivery of high-quality mental healthcare.
I think we can all agree that, in far too many respects, Mount Carmel Hospital falls short of expectations- Michela Spiteri
Two years later (and three years since writing that article), we are still talking about Mount Carmel. The discussion was resurrected at the beginning of the year when Belle de Jong’s account of her eight-day incarceration went viral. Her candid account told of a dirty and depressing hospital whose essential ethos hadn’t really changed since its foundation as a lunatic asylum in 1861. No wonder, therefore, she was kept in total ignorance of her condition or that she formed the impression that the institution existed to segregate patients from society rather than integrate them.
Her account was as vivid as it was candid: “All I knew was that I was in a sketchy building, with few windows and no natural light, where metal doors are heavy and slammed shut throughout the day, that seemed to come straight out of a horror film, with patients that looked more dead than alive”. And she went on to compare the showers, “with old cabins and chipped floor tiles”, to those bath houses of Nazi concentration camps where naked patients once huddled so pitifully together. Moreover, the administering of drugs, she said, was confusing, chaotic and unsafe, with patients’ names being shouted out along corridors in the hope of locating the right person. Dosages came in little pill boxes or were administered directly by hand.
There was absolutely nothing remotely far-fetched about this account. As someone who has quite recently visited patients at Mount Carmel, I can vouch for its accuracy: the rows of mismatched chairs (as if their backs are set against the world outside), the chipped paint on the walls, and, most disturbing of all, the ever-present slow shuffle of patients puffing on rationed cigarettes.
Yes, Mount Carmel is one of those places which I invariably leave with mixed emotions: sadness, gratitude, humility. And, yes, impotent rage too. Which comes from knowing that, however much you may want to help the person on the other side, there is actually very little you can do. You are never really allowed to question their treatment, medication or care. Quite simply, the metal door slams shut. Both literally and metaphorically.
I am not here to criticise members of staff. Far from it. De Jong herself praised them fulsomely as “qualified and lovely” and noted how committed they were to making up (as far as possible) for the dilapidated state of the building. She also had high praise for the treatment she received, which she claimed helped her out of her psychosis. And while I have absolutely no doubt that our doctors and nurses are proficient, qualified and caring, I have on many occasions questioned the long-term efficacy of medication that leads to a patient becoming merely ‘managed’ and, hence, institutionalised.
I am not here to point the finger at mental health professionals for using their powers inappropriately. Yet, it would be naive to think that this does not happen or that members of staff without exception move invariably with the times. It is a known fact that certain psychiatric drugs can cause new shakes and tremors.
And, similarly, I’m afraid, I can never quite shake off the feeling, when I’m visiting that Mount Carmel is anything but a place of healing. In the words of de Jong: if you aren’t mentally ill to begin with, the place will certainly drive you mad.
Something must be done.