'They will probably die here': Antigua's psychiatric patients' grim future

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At suppertime, the angry rebukes for sluggish behaviour appear more suited to a hostel for reprobate teens than a hospital with mental wellbeing at its core.
A glance at the evening’s meagre offerings of white bread and saltfish, dished out by a frazzled-looking nurse, suggests one reason for patients’ reluctance.
The woebegone state of Antigua and Barbuda’s psychiatric hospital, a conglomeration of rickety buildings on the capital city’s fringes, is well documented; the reality is jarring.
But the challenges go way beyond inadequate nutrition, beleaguered staff and crumbling infrastructure at this decades-old institution referred to in hushed tones by much of the islands’ population.
“It was enough of a feat to get the place an official name,” remarks the country’s principal psychiatrist Dr James King under whose care every one of Clarevue hospital’s 130 patients falls.
“It always used to be called the ‘crazy house’.”
Stigma runs deep
Stigma surrounding mental health in the Eastern Caribbean nation, like many of its regional counterparts, runs deep.
Patients can languish for decades among Clarevue’s confines, where they sleep in sparse dormitories, several behind steel barred doors, and visitors are as rare as running water.
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