Having had a close family member who suffered from a severe mental illness for the better part of his life, before he died of natural causes in a psychiatric hospital in the united kingdom, I have little difficulty in understanding the plight of people who are either suffering with a mental disorder, or with members of the family who also go through much pain and anguish. Many families in these difficult circumstances go through tremendous stress practically on a daily basis.
So when I was approached by a close relative of a patient at the KGV hospital who asked me if I could listen to a story regarding this relative with a view of making the story public. I was in all honesty surprised, but listening to this person I immediately began to understand what Alex was really asking for (Alex is not this persons real name, but with a family member as a patient at the KGV, Alex did not want the real family surname revealed) Alex in fact was looking for a receptive ear, and also to be listened to and hopefully understood, but also for the truth to be made known to the public. Ultimately what Alex wished was to ‘to improve the living conditions at this important public medical institution’
Alex came across as a genuinely concerned individual, as one would be I expect, when anxious about the welfare of a loved one. Clearly this was evident during our discussion. Alex close relative had been struck down by a mental illness and had taken up residence for treatment at the KGV, this had caused many sleepless nights in this household.
The main issue revolves around the condition and living standards at the hospital, something that Alex repeated many times was far worse than any ‘third world country’ being concerned for the welfare and well-being of a family member who is not only sick but psychologically vulnerable, must be the driving force in anyone’s mind, particularly in attempting to improve and change things for the better; Alex in this sense, was no different than anyone else in the same situation!
As I said Alex’s main complaint is about the conditions at the KGV. As matters were related to me, I also saw photographs taken illustrating what was being pointed out to me, they were shocking! Photos that would make most people cringe with horror and disgust:
‘How can our health services allow this to happen’ and how can this be happening in Gibraltar in the 21 century!
This is the full account of what ‘Alex’ had to say:
The KGV’s all in one ‘acute ward’
The acute ward is situated on the first floor of the KGV hospital; the ground floor is taken up by long term KGV residential patients. However it is the acute ward where members of the community are admitted suffering with psychological problems of different kinds and of varying degrees.
One of the first issues regarding the hospital refers to how all patients admitted end up in the acute ward. All admissions to this ward are made ‘irrespective of the sex, age or the type of mental illness a person is suffering from, be it drug related, psychological or behavioural issues or even depression’. The latter point of people admitted with depression will surprise many people, I know I was!
“I cannot understand”, Alex said “how people with a range of different mental illnesses of varying degrees can be admitted to the KGV, these unfortunate people suddenly find themselves plunged in amongst other patients, all on the same floor”. Just where is the clinical or medical management in that? Mixing patients like this, not withstanding their condition, sex or age group must be unique to Gibraltar’s psychiatric ethos.
Sleeping – and young patients who find it difficult to integrate!
As far as personal sleeping arrangements are concerned, there’s nothing personal about it, although sexes are segregated. There is little or no privacy; patients are allocated sleeping quarters which are normally shared between 2, 4 or 6 patients of the same sex and in one room. I am told that patients of both sexes are wandering all over the ward floor and privacy of any kind is impossible. Also that ‘young men and woman who are sometimes 19 or 20 or over, find it difficult to integrate into this hospital environment’
Recently because of increased female admissions the acute ward staffs have moved round sleeping arrangements to make available additional room to cater for the increase in the female population. This is something I am told that has caused a lot of distress and disruption to the patients themselves, resulting in a further drop in the quality of the living standards in rooms.
Rooms in a dilapidated state, no wardrobes or cabinets for personal belongings
Bedrooms are in a sorry if not dilapidated state; bedrooms are the more private part of the ward, if you can call it that. Paint on walls has flaked off, there are holes and broken partition walls that have not been repaired. The look and feel of the sleeping rooms are cold, dull, shabby and not fit to house any kind of medical patient, never mind one with psychiatric issues.
Another issue that appears to be in line with the state of the sleeping quarters ‘is the total lack in many rooms of wardrobes and cabinets to store personal effects’.
Many patients are not able to properly and safely store their personal belongings, rooms look disorganised, messy and one not fit for a vulnerable people to cohabit, I was told that on many occasions clothes and other personal items have gone missing!
Showers used as store rooms
You would expect that shower areas would have some level of hygienic improvement, the story here is not much better. In fact showers are being used as store rooms, they have been stacked with ‘portable disability walking frames, chairs and other bits of equipment’ towels funnily enough are left (see photo) on the chair that’s on the shower plate itself, just in case the patient is able to remove all the obstructions from inside the shower. Although I’m told hopes are dashed again of having a shower because the water mixer in the shower is broken.
Shower products I was also told are stored in the shower area commune style i.e. Shower cream, shampoo and sponges etc, if a patient eventually gets into the shower he or she would use the shower products available, including I imagine the same shower sponges which somehow does not appear very hygienic to me!
One more thing about the showers and something that can be appreciated in the photos, the shower curtains really looks to have seen better days.
But there is also the ‘important matter of leaving in a psychiatric hospital ‘acute ward’ ‘wired coat hangers lying about’ inside the shower.
This is a potential safety risk, where vulnerable people may do serious injury to themselves or to others or even worse! So much for health and safety.
Donated furniture does not get repaired
Another matter Alex raised was regarding furniture items, furniture according to what I was told is difficult to obtain, as furniture items are donated and more often than not are second hand and not repaired! It is difficult to think what kind of mental care is being delivered in Gibraltar. How can people who are already suffering inside with their own mental ailment be treated in such undignified manner, it truly is appalling!
Medication by envelope
Come medication time at the KGV, Alex has another story to tell, because medication which should normally be handed out to patients in small plastic receptacles to ensure that meds have been taken safely, are frequently distributed to patients inside a normal ‘envelope’ because plastic receptacles are unavailable or have run out.
I will say that Alex had much praise for the staff at the KGV hospitals - who are constantly working, mostly under stress; the conditions of work don’t help. Many of the staff are overseas nationals, who are also over-burden by having to perform extra shifts because of the shortage of staff. It is not uncommon for staff at the KGV to perform overlapping shifts, this cannot be good in anyone books. How are staff members expected to be alert and attentive to the needs of vulnerable patients if they work continuous roll-over shifts!
GHA cannot get it right at KGV
The KGV hospital has been the subject of much criticism over the years, the nursing section themselves have been one of the biggest critics, particularly regarding health and safety standards not being complied with. There have been deaths at the hospital involving patients, fires have broken out, even nursing reviews have been critical of KGV.
The Gibraltar health care development team said in July 2003. That the ‘mental health services continue to be the poor relation of Gibraltar’s health service.’
This team was right, but the KGV are not the poor relation any longer, they are it seems the totally destitute and forgotten relations!
People with psychiatric problems cannot wait for government to build them a new purpose built facility. These are some of the most vulnerable people in society, who not only expect, but deserve the best possible all round care and attention; this is something that takes many forms. Even if a new psychiatric unit is to be built, it is no excuse to allow the standards at KGV to go rock bottom, with dangerous practices in certain areas endangering the health and well-being of patients in general.
Health and safety at the KGV has again been ignored, shower rooms packed with hospital equipment causing danger to patients, dangerous articles left lying around, and medication handed out in a manner which is unethical in any clinical manner, particularly in such a facility. Reports of under staffing and staff themselves stressed out and having to work double shifts or more because of staff shortages are not good!
It is pitiful that government allows such a deterioration of this important medical institution; the KGV hospital is an embarrassment to Gibraltar. Promise of a new hospital is no excuse in allowing standards to drop like this. Inpatients recovery is being compromised by the visible deterioration at the hospital.
The KGV hospital as this article suggests keeps on falling short in health and safety standards and risk management. The appearance of the KGV inside and out is imposing, ominous; it does not look like a place where people would go to get well. It looks like a place where people would go, and stay and remain for a long, long time!
Mental health services in Gibraltar should be just as important as physical health services such as those for cancer and heart disease and many others. But it’s not!