This is the last of a five-part “Undercurrents” series examining the subject of mental illness in the Virgin Islands – its scope, its effect, and how it is, and is not, being addressed.
It’s been a long haul, and it’s far from over, but with fingers crossed, experts and advocates are anticipating a new plan for overhauling the mental health care system in the territory.
The genesis for the plan was a class action suit filed in 2003 by attorney Archie Jennings of the Disability Rights Center of the Virgin Islands. Joining in the suit were some of the non-profit organizations that work with the mentally ill: the V.I. Alliance for Mental Health Consumers/Survivors, Inc., Ten Thousand Helpers of St. Croix, and the V.I. Alliance for the Mentally Ill.
The government, in various divisions and individuals, was the defendant. Some players have changed over the years as the suit wended its way through the Court.
“This was just a vehicle” for forcing improvement, Jennings said. He believes the territory had a functioning mental health service into the 1980s, but it was dependent on federal funding. When that funding was cut, the local government failed to take up the slack.
It wasn’t Jennings’ first time suing the government over poor services for the mentally ill. An earlier case protested dilapidated conditions at the former Michele Hotel facility and the lack of services; there was not even a government psychiatrist at the time. Soon, the government opened the Eldra Schulterbrandt facility and also hired two psychiatrists on contract.
This time the case resulted in a settlement agreement and a consent decree, under which the two sides formed a joint commission to look for ways to improve the system. The commission was made up of public and private sector stakeholders, including advocates and family of the mentally ill.
Doris Farrington Hepburn, who has worked in the mental health arena for many years, became the director of the Division of Mental Health, Alcoholism, and Drug Dependency Services in June of 2010. The next month, the commission began its meetings.
“We worked steadily on that for three years,” she said.
There was help from consultant Mark-Chelle Inc., dba Athena Consulting, and the scope was broad. As Angeli Ferdschneider, special assistant to Gov. John deJongh phrased it, “We’re throwing everything in the pot.”
In August and October, consultant Prof. Chris Heginbotham came to the territory for a series of meetings with government leaders and non-profit groups. Jennings said he worked “to develop a plan based on available resources.”
The draft was expected this month, but it may not be made public until it gets approval from the Court and the governor. It will also go to the Legislature to be implemented.
In interviews for this series, experts have cited a number of things they see as necessary for good mental health care, many of them currently lacking. Among them are:
- better coordination of services;
- more support and counseling for families to help them cope;
- the reopening of the Juan Luis Hospital behavioral unit where patients in crisis can be stabilized;
- group sessions for families that accommodate their work schedules;
- a long term care facility on St. Croix similar to the Schulterbrandt facility on St. Thomas;
- a hotline for counseling and suicide prevention;
- jobs programs that provide people with a sense of purpose;
- more professionals on staff ;
- better understanding and acceptance of the mentally ill by the rest of the community.
Will the government have the money for the new plan?
“It’s not for us to find the money,” said Hepburn, speaking of the commission that worked on the plan. “People have to stop talking and put their money where the mouth is …It’s not an insurmountable problem …(but) we can’t do this alone.”
“It’s going to have to be a community-wide approach,” said Jennings.
If the plans to overhaul the system don’t work, the story for many families will continue to be like it is for Marla Matthew, who works with the St. Croix chapter of NAMI, the National Alliance on Mental Illness.
“I had to take my daughter off-island,” she said. “As of today – knock wood – she has been very stable for the last 12 years. But she lives off-island because that’s where she can get the services.”