Three to five daily suicide attempts presenting at hospital’s emergency services

Malta’s emergency services at Mater Dei are seeing around three to five patients reporting suicidal tendencies every day, Mater Dei’s chief of psychiatry Anton Grech has revealed.

“There is no exact statistic because there are many we never hear about, but a statistic is currently being worked on with regards to people who attempt suicide and end up at the emergency services at Mater Dei as a result of that. Approximately three to five people every single day are going to the A&E for this reason. It’s a lot,” Grech said on Radju Malta’s Ghandi Xi Nghid.

Grech, the clinical chairman of the Department of Psychiatry within the Ministry of Health, said that around 80% of suicide cases tell people around them of their intentions to end their life. “Most family members in fact go through a very difficult time due to the guilt they experience. Another side of suicide is that they are also often a result of a moment’s impulse,” Grech said.

Between 1995 and 2018, there have been 635 deaths owing to suicide – or two persons taking their life every month.

Grech’s reaction was one of anguish: “Unfortunately, Mount Carmel hospital is not fit for purpose, but that’s what we have and we have to work with what we have.”

Grech said the biggest problem in mental health was not the lack of provision of a cure but that very few people approach the cure willingly. However, he insisted, the case in Malta was that Mount Carmel was a very old building which had been abandoned to dilapidation and hazard. 

“One of our mission statements is that we no longer need Mount Carmel because people can obtain a cure from their community. It was an excellent hospital at the time but in the last few years, all its structural problems were revealed. It became unsafe. For renovation to happen, we have to move patients elsewhere, patients who have been residents there for more than 50 years.

“Fortunately, in the last few months, around 200 persons that we decided no longer need to reside at the hospital have been removed. The structurally worst-off section has been emptied of patients completely and will be demolished and turned into a therapeutic garden.”

Increased pressure of school life

Grech also laid some blame on academic life as building up unnecessary pressure on young and vulnerable students. “The education system is creating more than necessary tension in forming our character,” he said.

Three young individuals who shared their experiences with mental health issues in education spoke of having to deal with eating disorders, psychosis and bipolar disorder. Miriana Testaferrata de Noto said she faced up to her eating disorders when tracing them to a trigger when she was just ten years old. Liam Caruana, who works in a pharmaceutical company, described his difficulties with bipolar effective disorder, an illness that paralysed him for months and isolated him from peers. And psychology student Matthew Paris said that he had been experiencing psychosis for over ten years, an illness which bombarded him with visual and auditory hallucinations that came in the way of his studies and personal life.

All three individuals mentioned how their mental health problems started manifesting themselves at a time when they were vulnerable during their Ordinary examinations at the age of 15.

“What’s worse is that circumstances that should be offering recreation and opportunities for character development have been turned into examinations. To become a footballer, you no longer play out on the streets and in the field, but you need to submit yourself to a number of exams and tests. It’s unbelievable... the education system is creating too much tension,” Grech said.

Marijuana can cause mental health issues

Grech, who has already come out against the legalisation of cannabis, also expressed doubts on the efficacy of medical cannabis.

The top psychiatrist has already insisted that people with a family history of schizophrenia should not consume the plant. Schizophrenia is present in about one per cent of the population, that is, about 4,000 Maltese people. About 100 new cases are diagnosed every year in Malta but the percentage of people genetically predisposed to the disease remains unknown.

Grech said it is not just recreational cannabis that can be a threat to one’s mental health but medical cannabis too.

“When we refer to medical cannabis, we are talking about just an extract from marijuana, which contains around 400 components, the most common of which are THC and CBD. THC is the bad component, the one that causes psychosis. With CBD, there is some research that shows that it could be good against pain and certain anxiety.”

Grech said that what most people referred to as medical cannabis was not pure CBD and that some extracts still contained some other dangerous components, including THC. 

“There are some illegal strands of cannabis that contain just 2% of THC while medical cannabis can contain 5%, so it’s useless being so absolute about cannabis. Research is needed before we make certain statements,” Grech said, adding that sometimes doctors prescribed CBD for an ailment that research didn’t guarantee would be alleviated by CBD treatment.