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Published On: Wed, Nov 18th, 2020

Eileen Healy: “Not enough money for mental health care and lack of legislation”

PHILIPSBURG — The 2020 budget for the Mental Health Foundation from SZV is Naf 5,455,424. During the meeting with Parliament on Monday morning, November 17, former interim director of MHF Eileen Healy stated the budget was 4 million guilders. “It could be more,” she said. MHF also receives funding from stakeholders and sponsors, said to the amount of 2.4 million guilders. According to Healy, the funds are not enough for the 11.000 treatments performed on 581 patients so far this year. 

A total of 3,5 psychiatrists are needed to treat the number of patients on St. Maarten, the management of MHF explained to Parliament. The foundation has three psychiatrists but has an employment law dispute with one of them. These BIG-registered psychiatrists have been responsible for 80 percent of patients treated this year, almost all outside patient care. 

At the time of their presentation to Parliament, both Mrs. Healy and Dr. Pelswijk already knew for over three weeks that two psychiatrists had reluctantly resigned, one effective November 19, the other end of December. The Mental Health Foundation will promptly be summoned to court for breach of contract with one of the doctors. 

It’s not the first time Mrs. Healy argues with psychiatrists about employment conditions and quality of care. In 2018, BIG-registered child and adolescent psychiatrist Cheryl Ferero left after fights over work at MHF, as did psychiatrist Dr. Albertine Jurgensen-Mathurin.

Earlier this year, the medical staff of the institution sent a pressing letter to the president of the Board of MHF, Dr. Felix Holiday, stating that management had created a culture of fear among the employees of the institution. “This letter has been composed to inform you about reasons for termination of trust in the interim­ director Ms. Eileen Healy, intended director and current medical coordinator Ms. Kitty Pelswijk and HR officer Mrs. Carina Ellis-Romney, by employees, due to structural long-lasting mistreatment and abuse of power against employees of the MHF, in which we cannot speak anymore of good employer ship by the directors of MHF and the HR officer.”

The situation is affecting the health of certain caregivers, they wrote. “Ms. E. Healy is creating tension at the workplace, involving herself in the department’s situation, imposing to do things her way. The rules and regulations of the organization have not been updated since 2014, but staffs have to adhere to a lot of changes. In addition, management often references to policies that do not exist or have not been updated in years to argue their case against workers.” The medical team asked Dr. Holiday to intervene.

In 2017 a letter was already sent to the board of the MHF by United Federation of the Windward Antilles, citing the same problems. “Clearly staffs are still suffering and the situation is deteriorating,” UFA president Lloyd Beaton wrote this year. “We hope that this time we will be taken seriously. We hope that you as a board will not allow this structural problem to continue.”

In her presentation to Parliament, showing an organogram of the foundation, Mrs. Healy pointed out that interim-director Dr. Kitty Pelswijk is supported by six persons, overseeing Human Resources, day treatment. admissions, facilities, information and one acting as psychiatrist and medical coordinator. Mrs. Healy fails to mention that Dr. Pelswijk herself has been acting as medical coordinator and treating psychiatrist at MHF until she was appointed interim director on October 1. The position of medical coordinator at MHF is currently vacant.

In answer to a question from MP Melissa Gumbs about the treatment of patients from Saba and St. Eustatius, Mrs. Healy replied that the BES islands require BIG registration of psychiatrists and nurses. This condition would be the reason that for almost two years no psychiatrist has flown from St. Maarten to Saba or St. Eustatius for consultations. “We are trying to increase that service again,” Healy said. “Because they liked it and we liked it. But it was a legal issue.” However, MHF has had two BIG-registered psychiatrists for the past year. According to Healy, patients from Saba and St. Eustatius do come to St. Maarten for treatment. In the past year, however, zero patients from Saba have been treated in Cay Hill and only one from St. Eustatius. This gentleman has recently died of alcohol abuse.

According to her own statements to Parliament, Dr. Pelswijk was responsible for putting one patient in solitary confinement for 90 days and another for 60 days this year. The 90-day period started on January 7 this year and involved the 29-year old woman F.L. The other person in long-term solitary confinement was the late Caulette Julien, who was found dead on August 25. It had been reported to StMaartenNews.com that Miss Julien had been in the holding cell for three weeks, but according to the doctor’s statements she had been locked up for sixty days when she died.

Parliament did not question if this treatment of patients is even legal in St. Maarten. “Within five weeks after a person’s admission, the Attorney General shall send a copy of the notes referred to in Article 21, paragraph 1, with a petition to place the admitted person in the institution for a specified period, to the Court,” states Article 22 of the current law of St. Maarten. And Article 23 paragraph 6 reads: “By negative decision on the petition of the Attorney General, the Court orders that the person, whose further stay has been requested, be immediately released from the institution.”

The interim director of the Mental Health Foundation has never filed a petition with the Attorney General for solitary confinement of F.L. and Caulette Julien. Dr. Pelswijk points out that a second opinion has been requested from Dr. Michael Mercuur, board member of the Mental Health Foundation, who is a general practitioner by profession. Parliament has not considered how it is possible for a general practitioner to perform psychiatric evaluations that invariably lead to a signed declaration of the patient’s incapacity to give consent (KZ-verklaring).

The building in Cay Hill has one isolation cell, referred to by Dr. Pelswijk as “crisis room”. Management’s wish list for a new MHF building on another location on the island includes two crisis rooms, each 3.25 square meters. No mention is made of a toilet in these holding cells. Currently, a patient who is locked up 24/7 in isolation at MHF has to yell for help and wait to be escorted by a nurse and security to the bathroom. Mrs. Healy to Parliament: “Given the current number of patients, having three of these crisis rooms would not be a luxury.”

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Related articles:
Recording #1 – Parliament meeting with MHF
Recording #2 – Parliament meeting with MHF
Worrisome trend in mental health issues
Mental health patient dies due to possible overdose of medication
Mental Health Law not being applied
Distinction between natural and unnatural death remains unclear
Three months in solitary confinement, then deported
Solitary confinement belongs in the Middle Ages
MHF explains hiring process non-BIG Medical Professionals
Video images of Caulette Julien still not released
‘Black stock’ of antipsychotic drugs at MHF
Too many drugs: polypharmacy alarming trend at Mental Health Foundation
Medical liability issue gets attention from government
Psychiatric patient dead in solitary confinement
MHF response to article StMaartenNews.com September 22, 2020
Medical recognition divisive issue at Mental Health Foundation
Interim Director responds to publication about MHF turmoil
Mental Health Foundation in turmoil
Announcement New Interim Director Oct 1 2020

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