~ Healy: “Our clients are more confused than before” ~
PHILIPSBURG – “Only now the emotions are coming to the surface. We are very busy with crises,” says Eileen Healy, the director of the Mental Health Foundation about the psychological effects of Hurricane Irma on citizens. “In a month or two I’ll be able to present some numbers about the consequences of the hurricane.”
Healy says that what she sees right now is just the tip of the iceberg. “Many senior citizens who live on their own have become very frightened. You seen them cry, and they do not sleep well. And many of them do not come to us for help.”
The MHF-director says that addiction to for instance alcohol and gambling is going to be a huge problem and applicable legislation is not helpful. “The law does not recognize addiction as a disease,” she says. “So we are always looking for a psychiatric diagnosis to be able to treat addiction; otherwise we don’t get paid.”
In the aftermath of the hurricane, the Mental Health Foundation is also struggling with problems of its own. “We have an enormous staff shortage,” Healy says. “Schools have their own psychologists but we are falling short in the care for psychiatric patients. We have ten fewer staff members than a year ago. And the main cause of this is the government’s lack of vision on the continuity of care. Where do they want to go with mental health care?”
“Our tariffs have not been regulated by law,” Healy says. “Local institutions have to work with almost no resources and that is terribly unfair. SZV pays us 104 guilders per day for an admission and we have to be with those clients around the clock. How can you make ends meet like that?”
Healy says that the current MHF-team is working extremely hard. “But if you cannot make ends meet, how can you offer your staff a future? You must be able to offer them a career. There is enough to do here.”
The six apartments at the MHF building in Cay Hill are all occupied by in-house clients. There is only one crisis cell and there are nine admission beds. The foundation serves around 1,000 patients, an enormous increase compared to several years ago when the number hovered around 600. The MHF has one psychologist, two psychiatrists and three ambulatory nurses on the payroll.
“The nurses are on the road every day looking for our patients so they can get their medication. Some of them are psychotic and sometimes the police brings them here.”
Healy says that the protocol for mental healthcare has to change. “We need a building that is safe enough to harbor our patients before an event like a hurricane. Our impression is that our clients are becoming more confused than before. One man has been stabbed to death by one of our clients after the hurricane. We have to prevent such situations, but the way the government is looking at mental healthcare right now is not very helpful.”
Healy says that the St. Maarten Medical Center struggles with the same problem as the MHF: the tariffs for the services these institutions offer are too low. “All the focus is on the new hospital and currently all the money is going abroad. People at times stay away for three months for treatment.”
Minister Lee wants to bring down the costs for medical referrals – currently estimated at 30 million guilders a year – by improving local services through the construction of a new hospital. This would free up money for local healthcare providers.
The MHF does not only deal with its in-house and external clients. The staff also visits the Pointe Blanche prison twice a week. “Per visit we saw about ten people in two hours,” Healy says. “Now the visits have been stopped. They want to renovate the prison, or build a new one, but we are not involved in those plans. And I have been attempting to set up forensic psychiatry there since 2009. That can be done very simply.”
Attempts by the MHF to sign a memorandum of understanding with institutions like the Miss Lalie Center (for juvenile delinquents) and with the Court of Guardianship have so far come to naught. “They don’t want it,” Healy says. “Nothing is done about it.”
Photo above caption: Mental Health Foundation director Eileen Healy. Photo Hilbert Haar.
UPDATED
Response Minister Lee: “Outdated tariff structure is a challenge”

“I cannot answer for previous governments but the current Ministry of VSA clearly understands that caring for the mentally ill is a critical part of any healthcare system,” Minister Emil Lee said in a statement to stmaartennews.com.
“As we have been working to reform our healthcare system, mental health and the Mental Health Foundation as been included in our plans and strategies.
“The entire healthcare system in St Maarten is challenged by an outdated tariff structure that is dictated by outdated legislation. This is one of the driving factors for NHI legislation. In the meantime, we have been working towards a budget solution between MHF and SZV.
“Ultimately, the major issues surrounding many of our institutions is financial. MHF foundation is no different. The MHF has been without a director for quite some time, the current interim director, Eileen Healy, was appointed the beginning of October 2017. From before her time as interim director, the Ministry has been trying to resolve the financial issues. However, many of the issues fall under the control of SZV. While many people believe the Minister can simply instruct SZV what to do, that isn’t correct. There is a process to follow but we are working to find solutions.”
“The Ministry is working together with SZV and MHF to find a solution while we work towards a more permanent solution. Eileen Healy is a dedicated, passionate professional and we look forward to working with staff and board to find both short term and long term solutions.”