Lockhart hopes for farm therapy centre

Dr Marc Lockhart, Chairman of the Mental Health Commission

(CNS): As government moves towards developing a long-term residential treatment facility for those suffering with serious mental health problems, the HSA’s psychiatrist has revealed the goal for a therapeutic farm centre. Dr Marc Lockhart said that the climate was perfect in Cayman for a farm facility and such centres give a great sense of purpose for the chronically ill. Dr Lockhart said that if Cayman gets it right, the islands could become a centre of excellence for mental health.

Outlining his vision at the National Health Conference last week, Dr Lockhart explained the need for a such a facility and the trends in treatment. He said that in the first instance, the long-term care centre would allow Cayman to treat its own patients and bring back “exiled Caymanians”, many of whom are young people with behavioural problems who are receiving treatment overseas.

They were receiving much-needed and quality care, he said, but it was not home. Caring for “our own overseas is not right and it won’t continue”, he said, but given time, a successful therapeutic farm centre could also offer places to overseas patients.

With changes in psychiatry, doctors are recognizing the need for long-term care as well as early intervention, Dr Lockhart noted, and they are moving away from the high doses of complex mixes of drugs used in the 1990s to low-dose and therapeutic treatment, where patients are engaged in worthwhile and purposeful activities.

With 97% of the costs incurred by less than half of local patients treated in Cayman, Dr Lockhart stressed the need for a facility to meet the needs of a small number of chronic seriously ill people. There are only eight beds in the government hospital for mental health patients and the unit had a revolving door. Patients who come in are treated for a week and then they go back to their community with the same problems, so it is not long before they are back at the mental health unit.

He explained that a therapeutic farm residence would offer culturally sensitive, long-term, state-of-the-art clinical care and practical support for living. The centre would foster job-readiness skills, enhance social skills and support independent living. With the management of animals, growing fruit and vegetables, woodwork shops and a bakery, patients would be treated while also creating a commercially viable farm.

Government recently announced that KPMG has begun work preparing the outline business case (OBC) for a proposed long-term residential mental health facility but Lockhart said the need for this centre was identified many years ago. He said it was not a political issue as all governments had supported the concept but in recent times there had been a renewed vigour in making it happen.

But with some 4,000 patients being seen annually and a number of chronic problems, he said Cayman also needed to develop more outreach teams, especially with younger patients, so that medical professionals could also work with families of the patients. He also noted that mental health patients find it difficult to keep hospital appointments and so healthcare staff had to go them.