Saturday, January 20, 2018

An unfortunate incident

The more I read about the Cheryl Miller incident and the circumstances the more alarmed I become that this has happened. It paints a poor light on the Government of the day as the actions of one employee has brought the legitimate Government into disrepute with the populace that it governs.

When Ms Miller's employer exercised his/her right under the Mental Health Act to make an "application for urgent admission", she/he brought themselves under scrutiny for making a snap medical assessment of Ms Miller's mental state, where that person in all likelihood does not have the training to make such an assessment.

They called in the professionals, who following procedure proceeded to arrest Ms. Miller and through institutional practices conspired to deprive Ms. Miller of her right to liberty.

Let me try to explain "liberty" further. Liberty is freedom from oppression, subjugation, exploitation, unlawful restriction and discrimination. Liberty allows a person to express freedoms under the law.

The first cursory point is that the current Mental Health Act stipulates that an urgent admission can be done on the basis of an application by anyone, along with a certificate from a medical practitioner. Ms Miller's situation highlights many shortcomings in the law. Mainly and fundamentally, why is one citizen being given the right over another citizen to have their mental state assessed.

Moreso, the systems by which this is done, means that the person who is the subject is arrested and taken to a facility to be evaluated. The evaluation procedure is itself restrictive because the person has no right to be accompanied by a trusted colleague or family member (advocate). Was Ms Miller charged with a crime? It is evident where I am going with this. It allows for someone suffering a mental health crisis to be treated like a criminal thus robbing them of dignity and liberty. This is discrimination that has been legalised and is unbecoming of a nation striving to be recognised as civilised and developed.

The second issue I have with this situation is that Ms Miller was classified as an urgent admission. Was Ms. Miller a danger to herself? To others? Did Ms Miller have a previous history of mental health problems? Unless two out of three of these questions could produce an affirmative answer, I cannot understand Ms Miller being detained. It was reported that Ms Miller was asked to write a report on the event of her outburst and while doing so, the authorities arrived to detain her and remove her to St Ann's Psychiatric Hospital for evaluation.

Would someone who was a danger to himself, or to others or with a previous history of mental health react logically, follow the request and calmly attempt to draft such a report? It is because "urgent admission" is set as a standard by the law that it requires clear medico-legal safe-guards and must not be open to interpretive action.

Ms Miller's case raises questions about current best practice in Trinidad and Tobago. It would be better to describe the practice as inherited practice as there are no programmes to de-stigmatise mental health. There are no expressed programmes for the consultation on the creation of a better system for mental health in Trinidad and Tobago. The law still inadvertently treats someone with mental health as a criminal. There is inherent discrimination to someone who has been labelled with mental health as the label is itself derogatory in Trinidad and Tobago on a cultural level.

Lastly, this case is an embarrassment on the current government. It is also an embarrassment on all previous governments. This incident speaks volumes about the character of law in Trinidad and Tobago and the quality of health care in the country My own personal thoughts are that the person who called for Ms Miller's urgent admission should be suspended pending investigation.

Ms Miller should be released to her family with medical support for medications she has been administered and the Mental Health Act should be put under review by the Minister of Health.

Fabien Affonso

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