Sylvan Spooner on Select Mental Health Treatments in Barbados to 1970

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.

 

Example of a 1950s era ECT machine

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 21^st 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.

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[1] Personal Interview with Nurse Austin T (Retired)

[2] Personal interview with Observer A.

[3] Lawrence Fisher. Colonial Madness. Mental Health in the Barbadian Social Order. (New Jersey: Rutgers University Press, 1985) 190-191.