Consultants back CIG funded mental health facility

(CNS): An outline business case considering options for helping the growing number of people needing mental healthcare has concluded that the Cayman Islands needs its own therapeutic long-term residential facility that can accommodate local patients, those currently overseas and even medical tourists looking for mental health treatment. The report, released to the public Tuesday by consultants KPMG, found the best option was not the cheapest in the short-term but it would deliver quality of care, improved patient experience and flexibility.

Pointing to a price tag of more than $16 million to build the modular therapeutic facility, with cottages and a main centre and annual running cots of around $90 million, the consultants said the preferred option would provide a number of benefits over the other options considered.

It would offer care for local patients (who are currently either in the acute unit at the hospital being cared for by family struggling to cope or living on the streets) at an appropriate residential facility. It would allow more than a dozen patients who are now overseas to come home, and it would also offer services to medical tourists that could help offset some costs in the longer term.

Officials said that discussions are now under way between the health and planning ministries to identify a suitable site. Premier Alden McLaughlin, who is also the health minister, said he was delighted to proceed with the much-needed facility to treat mental health patients in a proper and fitting manner.

“This has been a long time coming, but my administration is determined to ensure that we achieve this important milestone in the healthcare we provide for our people,” he said following the release of the KPMG report. “Those who require treatment, often the most vulnerable in our society, will no longer have to be sent overseas and separated from loved ones to get the care they need. Importantly, instead of patients being locked up, or on the street, we will have the appropriate accommodation to help those who need it most,” he added.

For many years the Cayman Islands Government has been battling to balance the challenges of treating the growing number of people needing mental healthcare with the significant strains it puts on the public purse, however the OBC by KPMG looked at how the government could fund this project out of operating revenue and no new borrowing.

The programme includes the development of a single-access controlled site with therapeutic activities in an autonomous operation. The residential facility would be based on a modular design, with a central building and a series of nine small cottages to accommodate six patients, with two of the cottages to be built at a future date to meet demand.

While the project would require more cash outlay by government than other options, the consultants said it was the best choice for patients and would ensure that those receiving little or no help would get the care they need.

“The lack of residential facilities for long-term mental healthcare places stress on other components of the mental healthcare system, such as the acute care unit at the Cayman Islands Hospital,” the consultants wrote, noting that HMP Northward is also under stress because patients are incarcerated when they really need treatment. In addition, with no transitional facilities it’s hard to bring patients home from overseas care.

With a growing population in Cayman and research indicating mental illness is affecting more people around the world, the demand for care will increase, the consultants said, pointing out that the current system has limited resources to deal with an already growing body of patients in need.

Adding further justification to the need for the major investment, KPMG also cited a recent report which found that young people in Cayman were suffering from substantial levels of mental ill-health, including loneliness, anxiety, depression and suicidal intention, but the existing fragmented system would lead to poorer outcomes and more costly care.

The project outlines a facility that would accommodate up to 54 in-patients — around 40 locals and the rest being medical tourists. Although land has not yet been identified, it is expected the facility would be built on crown land and, depending on circumstances and the approval process that public projects are now subjected to, the centre would open at the start of 2019.

See the full OBC here