There was one prevailing common theme during the short meetings I had with senior staff at Mount Carmel Hospital last Wednesday – and this was the effort that is being made, as much as possible, to treat people with mental health conditions and return them to the community when they are deemed well enough to take care of themselves – just like people who recover from physical ailments at Mater Dei.

The main difference is that people who enter a mental hospital for treatment sometimes need to be given other forms of assistance during their stay there. They are taught the skills that we often take for granted that will enable them to live an independent life. Some of them will have lost these skills because of their condition; others have never learnt them.

And, just as nurses make home visits to assist patients recovering at home after surgery, there are the other nurses who visit these people in their home to offer them support and to guide them in their day-to-day needs.

It was the first time I had set foot in Mount Carmel Hospital. The impression I always had each time I drove past on the way to Rabat was of a small building, but this soon vanished as I realised that it is a much bigger complex than I had imagined from the main road.

And, as the day passed and my back-to-back meetings took place, it was easy to understand that I have a great responsibility in what I am writing, because each word, each sentence has only one aim, the one that pushed me into picking up the phone and asking for permission to spend one morning at the hospital to meet the people who work there.

This aim is to help, in a small way through this feature, to eliminate the stigma that surrounds this hospital and, even more so, the people who for one reason or another need to spend some time there.

I do not know whether I will manage to persuade you – it is one of the hardest articles I have ever had to write – but I do hope that those who read this feature and the one I will be writing for next week’s issue will be able to understand, once and for all, that mental illness is like any other illness. People can be treated and many of them recover, and there are many success stories of people who have spent months or even years in a mental hospital, but are now living the same life we do in the community.

Just as we go to the doctor with our physical ailments, or to hospital for the more serious cases, there are people who need support – through medication and other personal assistance – to overcome a difficult moment in their life. Not accepting them back into society, or making it difficult for them to settle down back within the community, will only compound their difficulties.

There was another thing I realised, as the hospital public relations officer Mikela Smith La Rosa took me through the various areas of the hospital – yes, even the wards and the rooms where the more difficult cases are treated. And this is the love, dedication and commitment with which the doctors, nurses and staff take care of the patients in their care.

One comment I heard encapsulates the extraordinary feeling there is between staff and patients. I heard one nurse say, referring to a patient: “She’s only been here for a couple of days, and I’m already in love with her.”

What else could I add?

* * *

My first stop was at the office of the hospital chief executive officer, Edward Borg, with whom I immediately engaged in a discussion on the stigma that surrounds people with a mental illness and the way those who are treated at Mount Carmel Hospital try to hide this fact from others.

“Thankfully, we have come a long way,” he said. “As time goes by, the stigma that surrounds mental health patients is diminishing. And this has come about because society has evolved and also because of awareness campaigns that have been run over the years.”

It is easy to stick a label, and it is easy to have a fear of the unknown, but it must be admitted that today society has made great strides forward. Of course, it is hard to imagine that the stigma will ever be completely eradicated, but the more society learns that there is nothing to fear and that mental illnesses should be treated like any other condition, the easier it will be for these patients to be fully reintegrated in society.

Mount Carmel Hospital was opened in 1861. Up until then, mental health patients used to be kept at what was known as Villa Franconi, where the Floriana Health Centre is currently situated. The use of Villa Franconi is behind the name “frankuni” for people who had mental health conditions – a derogatory term that is still used today.

Nearly 150 years ago, mental health patients were treated quite differently to the way in which they are treated today and one can imagine the degree of stigma attached to them in those days, said Mr Borg. “This is why they were moved from Floriana to Mount Carmel at 3 in the morning in July 1861. In those days, the terminology that was used for a mental health hospital was insulting by today’s standards. For example, it was common to refer to these hospitals as ‘lunatic asylums’. Thankfully, as the years rolled by, these names were discarded and replaced by more respectful terminology.”

Mr Borg said that over the last five or six years there has been a great push in three directions: the improvement of facilities, the strengthening of existing services and the establishment of new ones.

Millions of euros have been invested in improving the facilities offered at the hospital in order to make it as comfortable and homely as possible for the patients.

The services that are given at the hospital have also been upgraded. Being the only psychiatric hospital in Malta, Mount Carmel deals with forensic, acute, child, chronic and rehabilitative issues, all provided in one complex.

Society’s needs have changed over the years and, for example, it was only a few months ago that a ward that deals with addiction was opened.

The new services that have been introduced came about with the determining of a new way of treating mental health patients which is, as much as possible, to help them to recover and return to live within society.

Multi-disciplinary teams have been established so that patients receive as comprehensive a treatment as possible; apart from psychiatrists and psychiatric nurses, these teams are also made up of psychologists, social workers and occupational therapists who deal with the different needs of the patients to enable them to possibly lead independent lives, once they are discharged from the hospital.

Added to this, day centres have been opened in Qormi and Cospicua to welcome patients who are now living at home but need the comfort and reassurance of a place in which they can spend the day, or at least part of it. It is expected that more day care centres will be opened in the years to come.

Mr Borg said that outreach teams have also been set up to visit people who live in their own home but need both practical and psychological assistance in order to lead a semi-independent life.

All this has been done with one clear aim – to enable people to continue living in their community as much as possible. At present, it is only the more serious cases that end up in hospital on an indefinite basis.

“So much so that, whereas up to a few years ago we used to have 1,200 patients, today Mount Carmel Hospital is taking care of about 400 people,” Mr Borg said. “The new concept of helping people to continue living at home – with all the assistance required, where necessary – has led to many a success story. There were people who had been kept in hospital for many years, but are now leading a life similar to yours and mine in the community.”

Mr Borg said that the setting up of a crisis intervention team, which will be stationed at Mater Dei Hospital, is the next logical step. The team will be made up of psychiatrist, psychologist, psychiatric nurse and social worker, and will deal with emergency cases, such as distress calls from people about to commit suicide or others in despair following bereavement, for example.

“People with mental health conditions need all the help they can get, from their relatives, friends and specialised staff. We have widened our services and will continue to work hard to improve them, but society must do its bit too,” said Mr Borg.

This is the first part of an article on the services offered at Mount Carmel Hospital. The second part, which includes interviews with the specialised staff who take care of people with mental health problems, will be published next week.

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