The situation at Mount Carmel Psychiatric Hospital in Attard reads like a veritable horror movie. Perhaps all that is missing is a creepy soundtrack, but that is replaced by an even more eerie silence, punctuated by the sound of falling chunks of ceiling and gnawing rats – the background noise of a dilapidated hospital.

The former Chief Operations Officer at Mount Carmel Hospital, Paul Dalli, last week gave evidence in front of a parliamentary committee, and it was beyond horrific.

For patients with mental health issues admitted at the hospital, the simple process of taking a shower is a nightmare. The floor tiles in the bathroom are cracked and dangerous; there is no hot water because of years-long constant problems with the water boilers and so they have to have “freezing cold showers in the height of winter”. Most appalling of all, “they have to shower in the nude near each other with no privacy”.

What. On. Earth. Is. This? A Nazi concentration camp?

“I’m going to be blunt – I just could not take it any longer,” Dalli told the committee, giving the reasons why he quit his post.

 No shit, Sherlock!

This was the latest in a series of news trickling out on the state of the national psychiatric hospital. In previous months we learnt about the wards with condemn­ed ceilings; the scaffolding next to the beds to support the ceilings from the risk of collapsing; the metal support jacks holding old beams in place; the foundations with cracks so wide that rats sneaked in; and the battery-chicken-like wards with patient beds so crammed that nurses could not reach them for treatment.

Four centuries ago, the Knights’ of St John’s Sacra Infermeria was more hygienic, safe and private.

I mean, even if I am mentally fit but find myself lying on a bed, next to an unknown stranger practically breathing in my face, with an iron jack for a bedside table, and all I can see is a cracked roof, a rat waving hello, and people having a communal shower in the nude, it’s enough to make me need meds on a drip.

Incidentally, Dalli was being questioned by the parliamentary committee because of a National Audit Office report that had flagged suspicious employment during his tenure. In short, his recruitment office was very busy in the months – surprise, surprise – prior to the 2017 election, when he engaged a number of handymen to fix the hospital’s “disastrous state”.

It turned out, however, that those recruited were incompetent in maintenance work, and in many cases, other professionals would have to be outsourced to finish jobs. Dalli clarified that he had never employed any of them in licensed professional roles, but, erm, as “ladder holders”.

Ladder holders?

I see. Ladder holders. Because you know, when a hospital is crum­bling on its staff and pa­tients, ladder holders are your men.

Four centuries ago, the Knights’ of St John’s Sacra Infermeria was more hygienic, safe and private

In any case, since Dalli has left, there have been been some changes. Last October, Chris Fearne strutted in with his sharp suit and drainpipe trousers and told everyone that everything was under control.

He raised his eyebrow, and in the manner of James Bond told us: “The name is Prime Minister, De­puty Prime Minister. Mount Carmel dates back to Charles Dickens’ time and therefore I, the (Deputy) Prime Minister, will refurbish it.” 

Then as he was leaving the room, he turned round, raised his eyebrow again and said: “Oh, err, the hospital can’t be closed down, because hundreds of patients cannot go anywhere else since they’ve lived here for years.”

Come again?

Perhaps while having showers without worrying that he’ll slice his toe on a cracked tile, or that a chunk of ġir (lime) will drop down on his head, the Health Minister will have realised just how Charles Dickens his statement was. Here’s why:

1. Mount Carmel has more or less a total of 425 patients. How many “hundreds” of them have “lived there for years”? Surely in 2019 you are not meant to have “hundreds” of people living permanently in a psychiatric hospital, and as a health minister he should know that long stays in hospital never treat mental illness but make it chronic with worse symptoms.

2. Just because the patients have lived there for many years it does not mean they cannot be moved to a new, safer place. Unless, of course, that is just an excuse and the real problem is lack of staff. (Roof collapse and rats are not ideal in encouraging vocations in mental healthcare.)

3. How can it be that the government can’t source a temporary building to house these vulnerable patients? Does the minister realise that if the old St Luke’s Hospital had not been given to Vitals for 99 years – apart from saving ourselves €2 billion – it could have been gutted and remodelled as a safe house?

It is no consolation that as a country we pocketed €1, one measly euro, from Vitals, in exchange for all the equipment. Sadly one euro won’t get us far in the case of Mount Carmel – even the hourly rate of a ladder holder is more than that.

The truth is that even the concept of refurbishing Mount Carmel is dissolute. The world is fast moving away from taboo-inducing psychiatric hospitals. All we need to do is look at Trieste in Italy, which since the 1980s has closed down its 1,200-bed mental hospital.

Their mental health care is now made up of a psychiatric unit in the general hospital for relapses of chronic conditions; community mental health centres in various districts; and a network of supported housing facilities. All provide therapeutic, social and rehabilitative care and in places where usually one can’t tell who is staff, patient or visitor.

Can we do this, instead of wasting more time and money on Mount Carmel?

Data is showing a very worrying mental health situation in Malta: two people die by suicide every month; 20 per cent of the working population are suffering from mild or moderate mental health conditions; and it’s getting worse and worse. Tomorrow it could be me or you in need of mental health care.

How many more horror headlines do we need to get our act together on this unfolding tragedy?

krischetcuti@gmail.com
twitter: @krischetcuti

This is a Times of Malta print opinion piece

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