Sibetang case draws focus on lack of facility for mental patients

With the absence of a forensic psychiatry unit at the Division of Mental Health, Public Health Secretary Joseph Kevin Villagomez said the Commonwealth Health Center will not be able to adequately respond to cases of mental illness.
CHC became the focus of attention when Dwayne M. Sibetang, a mentally ill patient of the hospital, stabbed and killed Ma Dong Che, a Chinese nonresident worker, a week ago and injured Li Xing Fan.
Mr. Sibetang, 28, is now detained at the Division of Corrections although his lawyer insists that he should be transferred to CHC for treatment. The hospital has been having problems on how it would handle Mr. Sibetang since he has escaped from CHC many times and even assaulted a nurse at one point.
The case of Mr. Sibetang has put the island’s hospital on the spotlight again specifically its inadequate facility at the Divison of Mental Health to properly respond to mental cases.
Currently, CHC handles psychiatric cases that can still be maintained through medication. However, it does not have a place for people with severe mental problems who needs a 24-hour trained hospital guard.
“I don’t see us having one in the near future. It is not on top of our list because it is extremely expensive to operate a forensic unit,” Mr. Villagomez said.
With the limited budget of DPH, it cannot afford to build a forensic unit much more hire experts to handle these cases. Aside from this, the department would have to look for a big place where the facility would be located.
“We need to put them in a more home-like environment than just keeping them in a psychiatric unit. There’s no community hospital I know of in the world that has a forensic unit to it because that’s not the way it was set up to be,” he added.
CNMI officials had earlier attempted to forge an agreement with Guam to pool their resources so that it can establish a forensic unit for the use of the two islands. But such plan never materialized because of lack of funds.
As a result of this, the CNMI just like its neighboring island Guam, has been sending its mentally ill patients to Hawaii or the U.S. mainland, which has been eating up a huge chunk of the medical referral budget.
For example, CHC spent for the one-year stay of a local patient in a mental institution in the U.S. mainland. The patient is now back in the community. Two children were sent to facilities in Texas, also all expenses shouldered by CHC. The hospital is also in constant communication with hospital officials where the patients are staying to monitor the progress of their treatment.
But why can’t the hospital hire a forensic psychiatrist?
Again, DPH cannot afford to do so. A forensic psychiatrist is just like a pathologist which is not needed all year-round every single day.
The CNMI shares a pathologist with Guam right now. To put it bluntly, is it worth to pay $100,000 for a forensic psychiatrist for one or two persons?
Since the hospital does not have any facility, patients like Mr. Sibetang may have to stay with DOC while CHC ensures that they get proper medication.
While Mr. Villagomez acknowledges that people who are suffering from mental illness need immediate attention since they pose a risk to the community, the hospital simply cannot handle them either.
“The prison is not the best place for them, they should not be down there too. But our nurses are not security guards so we are looking at a place right now that offers the best possible solution for the community.” he said.