The Angoda Mental Hospital Case rebuttal

January 7, 2017, 5:15 pm 

I wish to draw your attention to the above article published in the Sunday island of January 1st 2017 and present my perspective on it as a psychiatrist, in order to prevent any misleading information about me and the National Institute of Mental Health, Angoda,where I serve as a consultant psychiatrist. It is my duty to inform the public about the story titled, "The Angoda Mental Hospital case……". I strongly believe that I have a right to reply as my name has been cited in the article, penned by un unknown author. However I will not go into details about the said case as I have an ethical duty to protect the patient’s confidentiality. Nevertheless I strongly object to and deny erroneous and malicious allegations leveled against me and the institution I serve, in the said article.

Rigorous Training

I have been working as a consultant psychiatrist for over 20 years in this institute. I have been certified as a specialist in the field of psychiatry by the post graduate institute of medicine in Sri Lanka, after five years of local and foreign training and passing the relevant examinations, also engaging in activities of continuous professional development. I also wish to state that I have been the president of The Sri Lanka College of Psychiatrists, which is the highest professional body with regards to the specialty of psychiatry.

Furthermore I am a member of the board of study in psychiatry over 17 years and the present chairman of the board. I had been the director of the National Institute of Mental Health for over 14 years and have made many significant changes to improve the quality of services provided by the institute to patients and their families. As a result I have managed to change the institute from a custodial hospital where patients and their families did not have much rights or dignity to a more humane and rights based acute care hospital. As a result of this achievement the National Institute of Mental Health was awarded the Health excellence award in all occasions and I was also selected as the second best director in a tertiary care hospital in the country in 2008.

On several occasions, the Rotary club of Colombo recognized my dedicated services rendered to Sri Lankan society. My service to mentally ill patients in this institute was recognized by the WHO Sri Lanka as well as WHO headquarters in Geneva. I was awarded ‘The Director of the Best rapidly changed mental health institute in Asia’ by the Asian College of Psychiatrists.

The person (referred to in the article) Mr. Harsha Thilakasiri was admitted to the hospital on the 10-09-2016 after having taken an overdose of his medication. This patient was admitted to my unit by the duty medical officer around 6 p.m. The patient was admitted by one Mr. Lankendra Thilakasiri(younger brother of patient) and he has signed as the guardian of the patient and one Mr. Chandana Ranasinghe as one of his friends. There had been similar kinds of episodes in his past since 2013 and he had been a patient of mine in the private sector. This patient was admitted under the Mental Health Act as an involuntary patient and prior to the expiry of 12 hours he was examined by the next senior level doctor who also has training in psychiatry for more than five years. Due to the continuous risk of suicide and significant foreseeable risk to self and to his mood, after explaining the diagnosis and the risks and benefits of alternative treatments available for this kind of conditions, we decided to commence a course of electro convulsive therapy.

We believed that this kind of patients would benefit quickly from this therapy after considering merely the clinical factors with my expertise in clinical psychiatry. The medical officer had also requested to keep a bystander, preferably a relative, for this patient. Furthermore, I strongly disagree with the statement that I have ordered electro convulsive therapy to satisfy a politician or an engineer. During the course of his stay in hospital, the treatment team had contacted his father, brother and girlfriend on several occasions and discussed about the management as well as how to manage him in society. I need to highlight that all the family members were very supportive of the treatment procedure and did not show any displeasure towards me or the treatment team regarding the treatment procedure. By September 20, the patient got well and he was mentally fit to be discharged to the community to stay with his parents. According to the policy of the hospital, the patient was sent on leave to his parents and subsequently reviewed on several occasions before ultimate discharge.

Unfortunately he has not reported for his clinic appointment regularly. Instead it appeared that he had gone to the media to criticize his treatment procedure. It appears that the patient, his family members, politicians as well as media personnel are not able to understand his illness and as a result all appear to be in a "confused" state and spreading rumours in an unwarranted manner. There are always people interested in exploiting the mentally ill. Having a vast experience in treating patients with mental illness and by knowing rights of the mentally ill population and as a person trying to upgrade mental health services in Sri Lanka it is an insult to me to state that I have acted in the way how the politicians want me to treat patients.

An equal chance

It would have been better - as we often see and read in other news media -if inquiries had been made of medical aspects of a presentation of a patient, an equal chance should be given to the medical practitioner and the specialist to express his or her specialized view as well. I too respect dignity, equity, fairness and justice as any other person in this country, particularly which your paper is apparently fighting for. In my concluding remarks I would like to mention that my experience of working for more than 20 years in serving as a psychiatrist in SL, is that when there is a difficult patient, difficult diagnostic issues, difficult management issues or when a politician is involved the media tends to sensationalize rather than investigate every aspect if the story. In my opinion, that’s what we expect from a Right To Information Act.

This (publication) has resulted in damage to my reputation as a psychiatrist which I have managed to build over years by treating most under privileged but most deserving members of Sri Lankan society. Please be kind enough to give the same publicity to my letter as you have given the article titled ‘The Angoda Mental Hospital Case’

Dr Jayan Mendis,

Consultant Psychiatrist,

Founder Director,

National Institute of Mental Health,

Angoda, Sri Lanka.