Mental health unit disobeys court order

| 07/05/2015 | 16 Comments

(CNS): A psychiatric doctor refused to admit a mental health patient who was ordered to the unit by the courts last month because she decided the patient was too disruptive and not suffering from mental health issues. Debbie Ebanks, who was serving a suspended sentence and who has long been known to the courts and social services because of her severe psychiatric problems and chronic self-medication with illegal drugs, breached the conditions of her parole.

Cayman News Service

HM Prison Fairbanks

However, because of her mental health issues, the court ordered her admission to the hospital for treatment rather than jail. But despite the clear order from the judge, Dr Arline McGill, who was on duty at the unit when Ebanks was to be admitted, refused to accept her and so she was sent to Fairbanks, even though she was in a psychotic state, the court heard Wednesday.

Work by officers at HMP Fairbanks, Prison Director Neil Lavis and the court staff eventually secured Ebanks a place at the hospital, where the same doctor who had declared Ebanks not to be suffering from mental health problems administered intravenous anti-psychotic drugs, the court also learned.

As a result of Ebanks ongoing problems, with nowhere for her to stay in the community and following the treatment at the hospital, she has been remanded in custody to serve the remainder of her sentence in relation to a robbery at Café Del Sol. During another psychotic episode Ebanks had gone into the cafe armed with a machete demanding carrot cake.

Ebanks’ attorney, Fiona Robertson, who outlined the shoddy treatment that her client had received, conceded that there was nothing left for the courts to do but to jail Ebanks and have her serve the remainder of her sentence at Fairbanks.

The situation surrounding Ebanks, who has a criminal record as a direct result of her mental health issues, having being diagnosed with a bipolar disorder, is one of many victims in the Cayman Islands with mental health problems that are being failed by a woefully inadequate criminal justice system.

Both prisons, which are ill-equipped to deal with the issues that inmates with mental health problems have, are currently taking the brunt of the country’s ongoing failure to address the lack of a suitable mental health facility.

Government is taking small steps towards the creation of a purpose-built mental health and psychiatric hospital or centre that will also cater to those patients caught up in the criminal justice system. A steering committee has been formed but Cayman is still years away from meeting the needs of the most vulnerable members of society.

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Category: Courts, Crime, Health, health and safety

Comments (16)

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  1. Anonymous says:

    as a former patient of hers, i am not surprised mcgill is involved.

  2. sam says:

    Tell this to your doctor:
    What the Body Requires to Produce Serotonin.
    Although much remains a mystery, we know that a state of mental health requires an adequate supply of neurotransmitters such as serotonin.
    The body must have protein to manufacture serotonin (and other neurotransmitters).
    To digest protein, we need to have adequate stomach acid.
    To produce stomach acid, we need to ingest proper amounts of zinc, B1 and B6.
    Stomach acid breaks down proteins into the amino acid tryptophan.
    To break down tryptophan into 5-hydroxytryptophan, the body must have a ready supply of folate, calcium, iron, and B3.
    To morph 5-hydroxytryptophan into serotonin (5-hydroxytryptamine) the vitamins and minerals B6, zinc, magnesium, and Vitamin C are required.
    So, without zinc, our stomach acid is inadequate to break down protein. The amino acid tryptophan cannot be transformed without folate or calcium. Without the presence of all vitamins and minerals required, no serotonin can be made.

  3. MISS Cayman Brac says:

    Patient confidentiality exactly.
    Why is her actual name out there for her and family to receive discrimination.
    A pseudonym could have been used. I am shocked.

  4. Anonymous says:

    Why not haul someone in front of the judge to explain?

  5. Anonymous says:

    We have a perfectly good facility for the mentally afflicted. However it only accepts inmates every four years.

  6. Anonymous says:

    I simply do not understand how a doctor can refuse to admit someone who is clearly psychotic so I have to assume there is more to this story than meets the eye. That said there is an enormous problem with the mental health services which seem to be out of touch with modern thinking, an ability to assess properly and are quick to diagnose and prescribe. I am fully aware that this case is different, however my experience is that throughout the hospital there is a lack of expertise in prescribing and doctors refusal to get a second opinion from colleagues puts lives at risk.

  7. Sharkey says:

    This issue is something for each and every one of us to seriously consider. The action of Dr . McGill is irresponsible and disrespectful to one’s health and care, and to override the Judge orders, and where is the health minister of the Islands in this case . Who gives the Dr permission to except, or deny the care in a public hospital ? I think that the whole health care system need a overhaul from top to bottom .

  8. Anonymous says:

    “Crazy” is incredibly common and normal: Statistically, 1 in 4 people will have a mental affliction of some kind in any given year (depression, anxiety, phobias, OCD, PTSD, panic and eating disorders). Many are undiagnosed, some are trying to find the best medical balance, and others at the most extreme end of the spectrum are truly lost to the systematic neglect and dismissal of society. 10% of young people have a mental disorder and this rate increases into adolescence. 3 in 4 do not want to talk about their struggle fearing stigma and discrimination. The whole planet needs to have a more sophisticated and pragmatic discussion about the scope of mental illness and realign our health priorities. It is part of the human condition that very likely effects either ourselves, or someone we love.

  9. Anonymous says:

    Unfortunately, in many instances, those afflicted with mental health diseases refuse to take their meds because it makes them emotionally numb and they cannot be forced to do so unless the situation is dire. The only reason I now take my meds is that I’ve been there, done that and this side is definitely better. Nowhere as exciting but way better. Hope Debbie can figure it out.

  10. Anonymous says:

    But for the grace of God we too could one day be a patient within the psychiatric ward. God forbid! Therefore it is worth taking time out to voice our concerns and make genuine suggestions of positive steps that could be taken to help those recover from depression or cope with bipolar etc. I had a very close family member who started having anxiety attacks suddenly and quickly fell into a state of severe depression. The first thing that was decided was to administer an anti-phsichotic drug which caused them to be very forgetful and dependent on someone to bathe and feed them. It was heartbreaking to see them look at their children and spouse and not recognise them. The strong medications that were administered to them caused hilucinations and suicidal thoughts. Although the side effects of the drugs were known, the doctor continued to give the same medications. Finally the patient’s family decided to seek medical help overseas to get another opinion. The doctors ran tests on the patient and found that the patient was severely deficient in vitamin D and vitamin B12 which can cause severe depression and lack of concentration. The patient lost 80 pounds in six months which was directly related to loss of appetite and depression. The doctors here had misdiagnosed the patient and the doctors in the US told the patient and the family that if they had continued taking the strong medication that had been prescribed by the doctor in Cayman, it could have been very harmful as the anti-psychotic medication is very strong and can be habit forming. which would cause an individual to become dependent on those meds until they would eventually need even stronger meds. So my suggestion is for proper evaluations of each patient to be conducted and not base one patient’s symptoms on another indivdual. The individual was in a senior position and had never had any history of mental problems etc., and once they were seen by a doctor in the US and came off of the meds and the doctor prescribed 50,000 units of vitamin D and vitamin B12 shots for six months. I am happy to say that after the first dose of each vitamin we were able to see a positve change in that individual. Thank God at the end of six months they were completely back to normal and currently holds a senior position with no problems. Sometimes it just takes someone to care to speak up for those who are experiencing such uncontrollable symptoms, so ask the doctor questions and do some research on your own as well. If a second opinion is needed, go for it!

    • Antonymous says:

      Yes, deficiencies in these two critical vitamins are responsible for many psychiatric ails as well as serious medical illnesses. And even though we are blessed with sunlight year round in our island paradise, shockingly, many of us are deficient in vitamin D. More doctors need to be routinely testing for this deficiency.

      Most of us need to be more nutrition conscious as well.

      And not to mention our lack of exercise.

      Lack of exercise and poor nutrition are laying a foundation for a major public health disaster for Cayman.

      The number of overweight and almost obese young women is frightening. And what is more frightening is that they do not seem to have a concern about it. Anyone who was at the recent Batabano parade can attest to the wanton display of the rather voluptuous and the clearly implied the bigger, the sexier.

      And please don’t get on the band wagon of size is off limits because of sensitive egos. We need to start facing the stark truth that our eating habits and life style in general are destroying our chance for a full and health life — and do something about it.

      Sorry If I appeared to have gone off on a tangent here — but our lifestyles are closely related to our mental and physical health, and so much of this is related to the simple decisions we choose to make every single day.

      • ellie says:

        The medical causes of psychiatric symptoms should always be considered. Especially for a person over 40 with no previous psychiatric history. Especially if a person gets worse when given antipsychotic or anxiolytic medications.

    • sam says:

      Agree with ,5.13pm. The only accurate test for B12 deficiencies is MMA test, urine preferably. 25% of people diagnosed with dementia etc. actually have B12 deficiency. With age, most people have low stomach acidity, NOT high, as doctors try to tell you, which in turn causes myriad of health problems, one of them is called “Intrinsic factor”, the inability to absorb B12, that is why sublingual application of the vitamin is required. Most people over 40 have reduced stomach acidity and should supplement with HCL with pepsin. There is information internet how to find right dose. The heartburn in NOT an indication of high acidity. Educate yourselffsmd your doctor.
      Secondly, take an adequate dose of Omega3 supplements, a good one, not from a stale capsules sold at a grocery store. The pharmacy at SMB clinic had good quality Omega3, better if stored refrigerated.
      Thirdly, always know your calcium serum level in your blood and serum ferritin (iron saturation in your tissues). These 2 numbers are very important. The former should never be higher than 10.2, not by a digit, and the latter be in 40-80 range. Investigate if it is not. Google is a great source.
      The last thing, without sunlight exposure one can’t have good health. Ditch sunscreens, cancers are not caused by sun. Educate yourself.

  11. Crappy care says:

    Psychiatric care on island is crap. Not only do we have the issues of long term in patient care , but we also have mainly one private practice psychiatrist who over prescribes heavy drugs for small children and he is not properly credentialed to serve youth. The chronically mentally ill start out as children and no one appears to be paying attention. Just like Debbie, we have kids who end up incarcerated when proper mental health care and psychiatric care was the underlying need. We have no qualified pediatric psychiatrist and the jails become our “holding” facility for the very vulnerable …. Debbie and so many others.

    While we can’t solve the problem of a inpatient facility now, We can expand quality psychiatric care through excellent service providers like CTMH. We can pray The Wellness Center expands services. We can support great providers such as The department of counseling services. We can become more vocal about shoddy providers on island. We can stand up to those doctors that care about money not clients!

    I’m sorry Debbie is now incarcerated and is not getting the treatment needed. I hope the lord watches over her as professionals are not.

    Get quality psychiatric care to cayman now.

    • Ellie says:

      @Crapycare, All parens must know that children with high lead levels are much more likely to drop out of school, have reading disabilities, and exhibit criminal behavior.
      Neuropsychiatric symptoms of chronic lead exposure include:
      Headaches
      Poor memory
      Inability to concentrate
      Attention deficit
      Aberrant behavior
      Irritability
      Temper Tantrums
      Fearfulness
      Insomnia
      Lowered IQ
      Neuropsychiatric symptoms associated with mercury toxicity include:
      Insomnia
      Nervousness
      Hallucinations
      Memory loss
      Headache
      Dizziness
      Anxiety
      Irritability
      Drowsiness
      Emotional instability
      Depression
      Poor cognitive function

  12. Anonymous says:

    What happened to patient confidentiality in regards to Debbie Ebanks? As well Anti psychotic medication is not givenIV bit IM through the muscle.
    the flaws in the system are the root cause of patient mismanagement and community failure to accept and deal with such patients.

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