Treating the mentally-ill

Editorial, Normal

The National, Monday 28th November 2011

THE prison is no place for the faint-hearted
Even hardened criminals dread it if, for nothing, then, for the fact that it robs one of that cherished right all animals including humans enjoy – freedom.
The prison assails the mind and affects different people in different ways.
It subjects one to physiological and psychological stresses that can confuse, disorient and create a subjective sense of loss, of isolation and loneliness.
Prisoners get anxious, tense, irritable and apathetic and, in some cases, they reach a point of no return where their entire emotional and mental make-up lose the ability to respond to and adapt to the predicament they are in and they snap or, as the Tok Pisin description goes, they become longlong.
This is not an unknown predicament and is as old as the prison system has been around in society. Today, prisons share the twin attributes – punishment and rehabilitation – but they once used to be reserved solely for punishment. And, there in prisons like France’s La Sant or Equatorial Guinea’s Black Beach and North Korea’s Camp 4, even the strongest sometimes snapped.
Prisons in PNG, fortunately, bear none or the nightmarish reputations of some around the world but they do have their own dire problems borne out of lack of resources and proper planning and policy.
Psychiatric counselling and treatment, for one, is lacking in all prison facilities – a condition that was, for the first time, highlighted by Minister for Correctional Services Sai Sailon Beseo.
Last week, Beseo decried the state of affairs as relates to assessment of prisoners presumed to be mentally ill and the treatment and care of those who actually are.
PNG needed a secure mental hospital and prison facility for prisoners who were mentally ill, the minister said. We agree.
There are no records, Beseo discovered, of the number of prisoners who are classified in this category throughout the country. He could not tell the media exactly how many inmates at the Laloki Mental Hospital are actually prisoners but, he admitted, there are some.
Laloki, it seems, does not only deal with those seeking assistance through the various referrals from the health system but also caters for and is holding patients who are referred by the courts or from the prison system.
“As the jails do not have specialist facilities or trained personnel, all prisoners who have psychological problems or those requiring assessment are sent to Laloki Hospital,” Beseo said.
The state of the mental hospital itself and the need for more such facilities and specialist personnel to staff them are subjects for another editorial, but the need for such facilities and specialists within the prison system is important for reasons other than humane care for sick people who need it.
They are also needed for the safety of the public for two reasons.
The presence of a person deprived of sense and of the ability to distinguish right from wrong is a threat to society. He or she can do anything, including harm, to members of the public simply because he or she cannot distinguish the difference.
Of grave danger to society are those criminals who fake mental illness.
Without specialist care, such a person can easily fool the warders at any jail that he or she is mentally ill and be sent to hospitals where they can easily escape. There are no records at present to tell us whether such a ruse has been used before but we are confident it has happened.
Using the weakness in the system, many a dangerous prisoner might escape. Of equal concern is the fact that a very ill prisoner might be kept imprisoned for the fact that there are no accurate and professional diagnosis and prison warders think the person is faking his illness.
Either way, proper psychiatric counselling and treatment is needed for all prisoners, not only those who outwardly display symptoms of psychological ill-health.
Many of those who end up in prison do need some sort of counselling to set them right in society. It should be a major aspect of the rehabilitation process.
In their absence, Beseo has directed the CS administration to look at a central holding facility at Bomana from which prisoners and those referred by the courts can be assessed and referred to Laloki for specialist treatment, care and rehabilitation.
We also commend the minister for his foresight in promising resources to upgrade a ward at the Laloki Mental Hospital to cater for CS patients.