I am reading with great sadness the articles published in the St. Croix Source in relationship with the lack of appropriate services for the mental health patients of Frederiksted.
I served for seven years as the charge nurse at the Mental Health Division (Dept of Health) at their Frederiksted location.
I worked along with a psychiatrist, one unit leader, two case managers/counselors, a drug dependency counselor that will see patients once a week and an administrative assistant.
When I started working there we had a complete area at the F’sted Health Center (FHC) to give our services to this very deserving section of our population.
We were able to provide adequate services because, besides an excellent and committed group of professionals, we counted with the following facilities: one reception area, where the administrative assistant worked, one doctor’s office, a nurse’s office, one unit leader office, one large conference room (where we kept our weekly group sessions) and two offices, one for each manager.
When the drug dependency counselor was at the site, he/she would use one of the managers’ offices as needed. We also had two bathrooms, one the use of patients and the other for staff members.
This setting provided appropriate conditions for the patients without the violation of their privacy as is required by the "Health Information Privacy Protection Act" (HIPPA).
When we moved, due to building problems, from the FHC to the Herbert Grigg Home (a move that was supposed to last about three months but it turned to be more than 3 years…), the Mental Health Unit was given the worst possible space.
Don’t get me wrong, we were very grateful to the Human Services Department for allowing us to relocate there but the conditions in that part of the building were terrible for both, patients and staff alike.
We didn’t have any air conditioning at all, the building was terribly hot, we weren’t even provided with phone services.
Later on we got one phone because, by pure chance, we exchanged a room with the Virgin Islands Perinatal Incorporated (VIPI) and a phone was connected in my office, an office that originally had been reserved for VIPI.
Some time after a phone was placed in the middle of the hallway, a phone that we shared with VIPI, where anybody and everybody could hear any conversation that was taking place.
Computers were out of the question at the time of the move. (Even working at FHC I had to carry my own personal lap top on a daily basis to be able to perform government duties).
Eventually, we got one computer because one of the case workers from Christiansted, that was transferred to F’sted, moved with the computer from her office at Charles Hardwood, where there is a computer in every office, and left it behind when she resigned.
In that setting there was no privacy at all for patients in spite of several complaints from my part. What was said in my office was heard at the HIV/AIDS program office across from mine due to communicating walls at the ceiling level and vice versa. I also counseled patients there so confidentiality was greatly compromised.
The doctor and a case manager shared a room (that later on was also taken over by the FHC to place their medical records and its staff) a next room was shared by the unit leader and the other case manager, meaning that only one patient could be taken care of at the time either by the Dr. or by the case manager if we wanted to preserve their confidentiality.
We didn’t have housekeeping services; we had to pick up our own garbage. I have seen my unit leader on his knees cleaning the floor of the office. Housekeeping from Charles Hardwood refused to go because they weren’t paid the hazardous duty pay employees are entitled to while working in dangerous areas.
As mentioned, we provided the services under those circumstances for 3 years!!!!
During that time several staff members, included me, retired at the time of the Government "Act 7261 Voluntary Retirement incentive program" in part due to the fact that employees with more than thirty years of service, like me, if we anted to continue working, besides the 8% that was going to be deducted from every government employee we would have been penalized with an extra 3% more deduction from our checks.
The retirement of critical staff members left the F’sted Mental Health Unit with only the psychiatrist and the unit leader. The other positions were never filled.
It took a couple of years before my position as a nurse was filled.
During this time the nurses at the FHC were mandated to medicate the patients that were receiving their injections once a month while the physician and the unit leader took care of the other aspects of the care of the patients like counseling and prescriptions.
When the FHC returned to their building at the Ingeborg Nesbitt clinic the situation of the Mental Health Unit didn’t improve, it only worsened:
The two case manager offices along with the conference room that the unit originally had was taken over by the FHC due to logistic reasons and now is even worse, they are only given a small space there. The new doctor assigned there, Dr. Sang, is refusing to go to deliver services due to the deplorable working conditions they have been left with.
We might even loose her, according to her words published in the Source (September, 2015) "Its making me feel like St. Croix doesn’t need me and maybe I should move on".
Mrs. Dina Cruz is totally right when in her letter also to the St. Croix Source states: "Without adequate treatment, these patients may potentially become a threat to themselves, loved ones and/or the community."
Thank you Dina for bringing these things to light!!!!
I related my experience working at the F’sted Mental Health Unit for everybody to know how things have deteriorated during the last years, and it seems that it will continue going down hill, the clinic has always been the step child of the Mental Health division.
What are we waiting for? For a tragedy to take place?
In the mean time who is doing something for these patients? Another campaign broken promise?
When will higher ups look into this matter and take action?
Do we have to wait until someone within a politician’s family is diagnosed with a mental disease for something to take place? We don’t have time to waste, the time is now.
It’s time to build; let’s build the appropriate services for our people.
Keep in mind, a mental health problem can happen to anybody.
And, please, Dr. Sang, do not leave; the patients in St. Croix need you!!!!
Maria del Pino Cruz, RN, BSN