SELECT
MENTAL HEALTH TREATMENTS IN BARBADOS TO 1970
By Sylvan Spooner
In the light of the plethora of modern treatment modalities
available for the care of the mentally ill or persons seeking psychiatric care,
it is nonetheless necessary to highlight some of treatments that were utilized locally
before the advent of modern antipsychotics.
One early and controversial treatment for the mentally ill
was the Prefrontal Leucotomy. Performed on disruptive and aggressive patients, it
involved the severing of nerves associated with the frontal lobe of the brain. Unfortunately,
in the few local cases in which it was performed, this treatment often made
patients regress to a child like docility from which they never recovered.[1]
Its risks outweighed its benefits and its practice was brief.
Other interventions were less invasive and one such
treatment (if it could be so termed) was known as work therapy. Through this, patients
were tasked with manual labor designed to temper psychoses or other unwanted
energies, which were believed to fuel impure thoughts and actions. A few
trusted patients, under the watchful eyes of attendants, would perform assigned
tasks on the hospital farm, its gardens or grounds during the period before
ancillary staff was employed for the upkeep of the facility at Black Rock. Its
therapeutic qualities remained questionable.
These therapies would give way to other treatment modalities,
which were feared to the degree that those fears remain fixed within mental
health folklore.
One such therapy was Anticonvulsive
therapy (ECT). By 1970, in the absence of a well-established system of oral and
Intramuscular treatment options, ECT, in a dangerously unmodified form (without muscle relaxant or anesthetic) had become an
accepted ‘treatment of choice’ for patients suffering from chronic depressive
and other illnesses where traditional treatments had failed. It was at the time
considered to be a necessary evil for those upon whom the cloak of mental
illness had befallen.
It was a violent affair. At times patients under its
influence would soil themselves or risk dislocating joints and fractures
because of the ‘violent’ nature of the process. One individual who witnessed once such procedure explained it
in the following terms:
It
is like inducing a seizure in a patient when you use the ECT…you had two pads
very much like headphones and you wet them and attach them to the patient’s
temple. To do the ECT the doctor needed at least four, sometimes six patients
on hand to hold the patient and you had to support all the joints. When the
current is switch on the whole body would contract and then they had a thing
called the *St. Vitus dance where the whole body would keep shaking for
anything like one to three minutes.[2]
Such was its violence, such was the fear associated with ECT
that one patient proclaimed that he “wouldn’t recommend it to a dog.”[3]
Mental health care continues to have its challenges well
into the 21st century but an examination of the past and the
treatments used in the care of the mentally ill can indeed provide critical
insights into why the stigma and fear continues to exist.