The plight of the mentally ill was recently highlighted when a mentally ill inmate of the Georgetown Prison bludgeoned to death another for no apparent reason. Other inmates then  ganged up on the killer and stabbed him to death, no doubt afraid that one of them would be next if he was not stopped. He was already on charges of killing two policemen in a murderous spree at the Brickdam Police Station.

A regional conference on mental illness was recently held in Georgetown during the latter part of last year. Press reports marked its commencement and conclusion but little public information as to its conclusions were made available. I would have hoped that the results of the conference would have gone some way in addressing the serious problems of mental illness which have been much neglected in Guyana and in the CARICOM region. Much of this neglect has to do with our general ignorance, lack of public awareness about mental illness and little active support for more resources to be devoted to this underfunded area of health care.

Lack of public awareness is very much responsible for the great deal of misunderstanding of and dismissive attitude to mental illness which currently prevails and much of the suicide which is so painful to so many. Much of the time mental illness is not recognized as a problem at all or as being responsible for specific behavior patterns among those afflicted, particularly young people who are more prone to suicide that older folk. Manifestations of such illness can result in assertions that the person is ‘playing tricks.’

Many families are at a loss and suffer great distress when a family member becomes ill. A physical illness is easy to define, to see and to accept. No manifestations of such clarity appear in mental illness cases. More often than not the patient does not know and is bewildered at what is happening to him or to her. Parents and other family members become gravely distressed.

The lack of awareness is responsible for the absence of pressure within the society to end the abysmal treatment, or lack of treatment, of the mentally ill who roam the streets because families cannot cope with them or who commit suicide because of depression which is untreated. I am sure that the people who manage the health sector are committed and responsible but resources are scarce and their capacity is therefore restricted. The fact is that the government is always faced with the challenge of allocating limited resources to areas in need. To attract the government’s attention to the mental health situation, public awareness must be enhanced so that the public will take the necessary steps to convince the authorities to devote more resources to the care of the mentally ill.

Public attitude to mental illness has been improving slowly although not much improvement is seen in Guyana. Between 1976 and 1980 Peter Sutcliffe, who became known as the Yorkshire Ripper, murdered thirteen women. At his trial in 1981 he claimed that he was told by God to murder the women. Four psychiatrists examined him before the trial and found that he was suffering from paranoid schizophrenia, a devastating mental disease that, if untreated, can potentially lead to violence. The defence of insanity was rejected by the jury and Sutcliffe was sentenced to life in prison. Shortly after, he was transferred to Broadmoor Hospital where he has since been under treatment for schizophrenia.

The case of Peter Sutcliffe contrasts sharply with that of Vince Li which occurred in 2008 in Canada. In a bus, at night, on a lonely highway, Li whipped out a knife and ferociously stabbed to death a fellow passenger, Tim McLean, next to whom he was sitting. He then beheaded the body, dismembered it, ate parts, and when he gave himself up the victim’s ear, nose and tongue were found in Li’s pocket, presumably for subsequent meals. Li claimed that God had told him to kill McLean because he was evil. He had cut up the body to prevent it from coming to life again. Fortunately for Li, although he had never been violent, he had been previously diagnosed as a paranoid schizophrenic, had been on treatment but had stopped his medication thereby causing his delusions to rage unchecked. Despite public outcry, Li was found to be not guilty by reason of insanity.

A quarter of a century between these cases during which public opinion became more enlightened was responsible for the fact that Li was not convicted but confined because of his illness.

In Guyana there is not much visible change in approaches. The mentally ill are either hidden away or roam our streets in unkempt conditions without any apparent effort to provide the means where they can obtain treatment. Many of them are hostile even though their behavior can be moderated by medication. Much stigma still applies to the mentally ill.

In our justice system, particularly at the level of the Magistrates’ Courts there is little evidence either that Police responsible for prosecutions or Magistrates are sensitized to the issues of the mentally ill or to identifying mentally ill offenders. Many are merely charged, placed before the courts, remanded pending trial or convicted and sentenced to a term of imprisonment. The mentally ill should be in hospital rather than in prison.

A mentally ill patient who kills and is not under treatment or is not taking his/her medication, or is not institutionalized where he/she could be a danger to the public, is likely to kill again. The prison authorities should have known this. It’s their job to be sensitized to these dangers.

For those concerned with the situation of the mentally ill, public awareness is the first step. It is to this end that this article is dedicated.  (www.conversationtree.gy).