"A Prison Cell is Not a Psychiatric Ward": UPP Calls for Screening at Prison Intake and Mental Health Professionals in Schools after Shabazz Death

The United Progressive Party (UPP) says the death of Rashawn Shabazz following a police-assisted cell extraction at His Majesty's Prison last month exposed a system that treats mental illness as a security problem rather than a medical one, and it is proposing mandatory psychiatric screening at prison intake, clinical rather than custodial control of treatment, and mental health professionals embedded in the school system.

The proposals came in the final segment of Observer Radio's The Big Issues on Sunday, where St. Paul candidate Franz DeFreitas and Senator Jonathan Wehner, joined earlier by Opposition Leader MP Jamale Pringle, were asked how a UPP government would be handling mental health in prisons and in the wider community.

Shabazz, 35, died on July 23 after a police-assisted extraction from his cell, during which rubber bullets and tear gas were reportedly used. His father, Khalid Shabazz, says his son had lived with mental illness for more than 15 years and that court orders directing he be housed at Clarevue Psychiatric Hospital (CPH) were never enforced. He has called for an independent investigation, arguing the police should not investigate a death involving their own officers, and led a picket outside the prison on August 20th that DeFreitas attended.

'Not a Security Problem'

DeFreitas stated, "I don't think anyone listening to the programme this afternoon can suggest that the current system that we have is working. Mr. Shabazz is not the only person who would have been a victim as a result of having mental health issues in Antigua and Barbuda."

"A prison officer is not a psychiatrist, nor a mental health professional. A prison cell is not a substitute for a psychiatric ward or facility," DeFreitas continued. "A mental illness cannot be treated primarily as a security problem, which is what we are doing now."

A UPP government, DeFreitas said, would introduce mandatory mental health screening at prison intake, periodic reassessment, "clearly defined clinical classification", and an individual treatment and crisis-management plan for every inmate with a diagnosed condition, "whether it be as simple as depression or as advanced as schizophrenia".

"Where specialised psychiatric treatment is necessary, medical professionals – not prison administration – should determine the appropriate clinical response," he said. "And we currently do not have that system."

DeFreitas said the problem is not confined to those who arrive at the prison already ill. "You know how many persons, when I went to support Mr. Shabazz, told me their child is in there, and the child went crazy in jail? The purpose of the prison is just to be a place where people mete out their sentences. People shouldn't be punished further when they go to prison."

'Clarevue is in Need of Everything'

Senator Wehner said the country cannot fix the system without first admitting where it stands – and read an excerpt on the CPH from what he described as the most recent report of Ombudsman Dr Marion Blair, whose tenure as Ombudsman began in 2016.

According to the passages he read, a promise was made in the 2017 budget debate to clean up the hospital; six years later, the Ombudsman wrote, there had been "no clean-up, no rehabilitation, no renovation, no respect for human dignity". The report described the institution as "mired in scandals of inappropriate sexual encounters, sexual favours, corruption, and sadly, the untimely death of a young female patient", and said criminal elements from the neighbourhood had taken over the abandoned maximum-security ward as a hideout – so much so that, shortly before the Ombudsman's visit, police had chased armed suspects through the compound, the suspects escaping over the chain-link fence through grass "standing taller than a man".

The report also recorded a safety and security petition, dated June 12, 2023, and signed by 113 CPH staff, complaining of threats of violence from relatives and intruders, criminals and vagrants entering through gaps in the fence, the absence of security personnel, inadequate staffing, a lack of protective gear, no training in patient restraint, poor lighting, the need for a generator, and decrepit wards in urgent need of refurbishment. Observer previously reported seeing a copy of that petition, which was reportedly sent to Health Minister Sir Molwyn Joseph, the Prime Minister and other senior officials.

"She concludes: the CPH is in need of everything," Senator Wehner said. "That is the Ombudsman of Antigua and Barbuda... describing the current state of affairs as it relates to our psychiatric hospital."

He drew a stark conclusion. "This might sound crazy, but it might even be better that some people were on the street rather than being at Clarevue, because you're talking about people who are being sexually assaulted, as reported by the Ombudsman. You're talking about bullets being fired at the facility meant to house you. You're talking about criminals using the old maximum-security ward as their operations HQ," Senator Wehner said. "So, we in Antigua and Barbuda, for years, have not been helping the mentally ill at the CPH. We have been making their situation worse."

Host Barbara Arrindell noted that the government has said patients will move to a new facility. DeFreitas questioned how long ago that building was purchased and said he had heard, anecdotally, that a regional body which walked through the site had advised that a psychiatric facility could not be located there.

When the Only Door is the Police

Arrindell added a personal observation: unless a relative with a mental health crisis has done something to endanger themselves or others, families cannot get them admitted for care – the police must be called to take the person in. She said she first encountered that rule some 30 years ago, when a young woman wandered into a church function, and it remains the case today.

"If my blood pressure is high, I don't have to have the police come and tell me I'm sick," she said. "This person has a mental health [condition]... it's different, but similar, because it's health."

Co-host Eddie Smith raised a more basic obstacle: the Clarevue administration is on record saying it cannot admit more people because the facility cannot handle the numbers – an issue, he suggested, that ought to be treated as an emergency.

Children in Prison, Deaths in Custody

Senator Wehner said the same disregard extends to minors. He cited the Ombudsman's 2022 report on children as young as 13 being held at His Majesty's Prison alongside adult offenders and deprived of their right to an education, despite the Child Justice Act requiring a separate rehabilitative facility, even as the Boys' Training School was under renovation.

He also noted that Khalid Shabazz's request for an independent investigation into his son's death has gone unanswered. "Have you heard anything from the government about how they are going to conduct an independent investigation? " Senator Wehner asked. "They don't feel like they owe any explanation, when we are the ones who hire them? These are questions that need answers."

"Somebody who was a known mental health patient – people like that should not be in prison," he said.

Catch it in the Classroom

DeFreitas' longer-term proposal is to build mental health screening into the school system, the way immunisation records are already required for primary school entry.

"I am proposing that at the very basic levels of our education system, we use that level to flag mental health issues that may not be mental health diseases at this point, and provide within the school structure – if not every school having a trained mental health professional – clusters and zones where that person visits, deals with the counselling, finds the solution, utilising the Department of Social Transformation and the department responsible for health and wellness," he said. The aim, he said, is to intervene "so that it does not become a mental health crisis where the child has to be extracted from the educational system".

He pointed to the visible toll on the streets of St John's. "All you have to do is come out to Redcliffe Street Monday morning and see how many people clearly have mental health issues," he said. "I look at somebody and say, this boy can't be 18... The people we see out on the streets is just the tip of the iceberg, because there are families that are fighting, families that are holding on, families changing their family structure to take care of the incidents."

Adults, he said, are affected too, "and add to it the pride and the shame and the stigma of seeking help". "We have a crisis in Antigua, exacerbated by substance abuse, exacerbated by economic depression, exacerbated by the stresses relating to running a family, maybe as single parents, or maybe traumatic experiences, and we need a comprehensive, government-driven solution," DeFreitas said. "It's hard like hell to deal with."

MP Pringle, before leaving the studio, had placed mental health at the centre of the party's crime agenda. "We have to strengthen mental health treatment in Antigua and Barbuda, because treatment is not only giving medication; we have to ensure that proper facilities are available to treat these problems that society is facing," he said. "Those things must be a priority and would have been a priority for the United Progressive Party had we taken office." He also flagged marijuana use among under-18s as a driver of long-term harm, saying "if you're damaged from such a critical age, it's difficult for you to gain back that type of mindset to be a productive citizen."