Psychiatry News and Blog

The Grim Future of Antigua’s Psychiatric Patients

The challenges faced by the Antigua and Barbuda's psychiatric hospital, Clarevue, are much more than just insufficient nutrition, beleaguered staff and a crumbling infrastructure. Dr. James King, the country's principal psychiatrist, under whose care the patients are, says in a discussion with the BBC correspondent, that it was a struggle to even get an official name for the place; it was always called the 'crazy house'.


This stigma associated with mental illnesses runs deep in most countries and it is no different here. Most patients here hardly get any visitors and they reside in sparse dormitories, many behind steel barred doors. Dr. King mentions that many could have been discharged if only their families cooperated. As per him, many patients were in the hospital since 1950s and will, probably, also die there.

The issue

Dr. King admits that the infrastructure is horrendous with cracked walls, toilets that don't flush and a total lack of maintenance. He further quotes that the matters remain the same despite writing to successive ministers, who keep claiming to fix things, but have not acted upon the same.Clinical social worker Ms. Pauline Christopher sums it up by saying that it is an ignored sector as it only costs money, instead of making money.

She further states that the staff does the very best that they can, but that their morale is very low. The terrible conditions have resulted in many staff strikes in recent years. There has been no official comment from the Ministry of Health on this; however, it seems that an upgrade of the facilities is listed on priority in the current budget with an amount of $141,000.

Factors that come into play

The mental health legislation of Antigua, in existence since in 1957 is currently under upgrade. While many patients are said to suffer from schizophrenia and bipolar disorder, Dr. King feels that it is the use of hallucinogenic drugs and potent strains of cannabis that lies at the root. Ms. Christopher feels that things are made worse due to the social acceptance of marijuana, which keeps bringing people back.

Matron Althea Blair, who has been working here for 14 years feels that witchcraft is also to blame for the situation. People take patients to pastors instead of doctors and then end up praying for a cure, stop medicines, and in turn land back in the facility. Miraculously, despite all this, a few patients are cured.

The need

Increased funding can help them to expand to help even people with eating disorders, children as well as adolescents, says Dr. Teri-Ann Joseph, the senior house officer. Dr. Joseph further says that they need a new facility, and would like to strengthen the presence of mental health in the ordinary health care. That way doctors get to spend time with patients, can look for the signs and work with them to start the treatment. That could help fight the stigma associated with these disorders, because the tendency of people is to usually shy away from what they cannot understand.

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