Monday, February 19, 2018

'More young people admitted to mental institutions'

THREE weeks ago Health Minister Dr Fuad Khan in reporting that more than half of the patients at the St Ann's Psychiatric Hospital were not supposed to be there, also noted that the hospital was seeing a "high incidence" of young people being admitted to the mental institution for "psychosis as a result of marijuana and alcohol".

Dr Varma Deyalsingh, secretary of the Association of Psychiatrists of Trinidad and Tobago, says that in the past three years the institution has been seeing more young "polysubstance" users and he called on the Ministry of National Security to do more to get the drugs off the streets.

Deyalsingh said when they see people with drug-related mental problems they handle it in a manner that patients can be calm and not undergo withdrawal, which in itself is a problem.

In a phone interview with the Sunday Express last week, he noted that after patients are detoxified over a two-week period the doctors try to convince them that they have a problem that is affecting their family and community, and they need to go for rehabilitation.

He said Caura Hospital has an excellent programme at their Substance Abuse and Prevention Treatment Centre run by Dr Winston Gopaul.

Deyalsingh lamented that the majority of patients did not want to go rehabilitation, saying there was "nothing wrong" with them, and therefore there was a "revolving door admission" with patients returning after a few months.

"It's a level of frustration we have," he added.

He said the problem that mental health caregivers faced was that after patients got clean, they could go out on the streets and get marijuana on any corner because it is so easily accessible.

He noted that while people liked to blame the Health Ministry for the problem, the Ministry of National Security needed to "get their act together" in the fight against drugs, and there must be partnership.

"If the Ministry of National Security doesn't do something about the sale of marijuana and drugs outside we will be losing this battle," he stressed.

Deyalsingh said it was "amazing" to see the number of marijuana fields being destroyed and no one being held by the police.

He pointed out that studies have shown that drug intervention programmes decreased both criminal activity, as drug addicts eventually get involved in some type of crime, and HIV infections, as people in their disinhibited state will "go out and get it".

He said the reduction of alcohol abuse, linked to emergency admissions in hospitals, also "has to be actively pursued".

To address this issue he called for zoning of bars, as there were too many near to schools, and more control of alcohol advertising.

Deyalsingh said that usually there were a lot of depression-related illness patients coming to St Ann's, followed by schizophrenia and mood disorders.

He noted that while depression cases were "still up there" they were seeing a lot more polydrug abusers with psychotic episodes or drug induced psychosis.

He said that there were drug induced psychotic disorders that could result in delusions, including hearing voices and seeing things; drug induced mood disorders which causes fluctuation in mood and depression; and drug induced anxiety disorder which causes anxiety attacks.

He explained that psychosis is an abnormal thought pattern which could manifest in delusions, hallucinations, illogical thinking and false beliefs such as people wanting to kill you or that you are a secret agent. He said these cases were "overtaking" pure schizophrenia.

They were finding substance abuse psychosis in the 25 to 40 age group and the substance combinations were either alcohol and marijuana and cocaine or all three in some cases. Deyalsingh said some of the warning signs that your child may be a drug abuser include: problems with relationships, irritable with parents or siblings, aggression or the opposite extreme withdrawal, change in personality, daydreaming or being "spaced out".

He further explained that marijuana in particular could cause "amotivational syndrome", where they are not motivated to work, study or be in a relationship.

"(They) in their own world, not interested in society," he said.

Some of the other symptoms of marijuana use are euphoria, the young person would be laughing a lot, impaired judgment, memory lapses, reduced attention span, fatigue and reddened eyes. He said cocaine may manifest in: loss of appetite, very talkative, very jittery, hyper alert, agitated, insomnia and paranoia. Alcohol abuse symptoms include impaired coordination, nervousness, hand tremors, slurred speech, mood swings, emotional instability, and decreased inhibition.

He said with the decreased inhibition people would drink, go out and have sex with a prostitute, get into a fight, or be in a stupor.

He advised parents who suspect their child is on drugs to look at their friends, check whether they are leaving home often, as they may be going to buy drugs, and for darkened lips which may be from smoking marijuana.

He also advised them to check around the house for drug paraphernalia such as: stems, seeds, small Ziploc bags, bongs (pipe for smoking) and cigarette paper for marijuana; little pieces of foil for cocaine; and alcohol bottles.

"The parents have to be observant," he stressed.