Bellevue Hospital has the legal responsibility to accept all persons needing psychiatric care and is committed to:
Provide medical, nursing and rehabilitative services in a clean and safe environment, aimed at returning individuals to functioning levels in their community in the shortest possible time with referral to appropriate agencies, while facilitating teaching and research.
Bellevue Hospital, as it is known today is situated on 123 acres of land on Windward Road, Kingston, Jamaica, West Indies. It came into existence as a separate institution for the care and treatment of Mental Disease in 1861. Prior to this, it was connected to the Kingston Public Hospital and was known as the Jamaica Lunatic Asylum. About this time reforms were taking place throughout Europe. This might have influenced the hospital Administration then, because conditions to which patients were subjected previously were improved. By 1868 there was the introduction of newer concepts of therapy, chiefly occupation and amusement, which abolition of unnecessary seclusion and the complete removal of mechanical restraints.
The community was becoming more appreciated of the hospital facilities provided and consequently more patients were being admitted with the increase admissions came overcrowding and new wards were built to accommodate the population. The recognition of the role of the hospital came into being in 1938 when the name was changed from Jamaica Lunatic Asylum to Jamaica Mental Hospital. By 1945 the resident population had reached 2,350 patients and overcrowding was more evident. Maximum accommodation available was for 1,819 patients. This caused some retardation to recoverable cases and deterioration in chronic cases. At the same time patients were having less nursing medical cases, as there was no corresponding increase in quality or quantity of nursing or medical staff.
‘Staff unrest’, a general atmosphere of frustration, complaints of inadequate salaries and unsatisfactory working conditions led to a strike of the nursing and sub-ordinate staff in 1945. This brought some change in the hospital and progress as a direct result with ultimate benefits to the patients. Steady progress continued in the following year 1947 with the introduction of Electro Convulsive therapy and Insulin Coma Therapy. Provisions were made for more organizing training for medical and nursing staff. Tranquilizers were introduced shortly after and this proved very effective in the control of patients. Custodial care was largely the recognized pattern of nursing care. The main emphasis was attending to the patient’s physical needs, maintaining discipline and controlling the patient’s behaviour. The main function of the nurse was keeping the wards clean and neat. Little thought was given to the emotional needs of the patients. In 1949 School of Nursing was established.
In the mid 1950’s the need for planned Occupational Therapy was recognized. Two members of the staff were set up in Occupational Therapy Centre. Other intramural provided at this time were limited to a number of specialize Psychiatrist, Psychiatrist Social Workers and Nurses.
The day hospital built in 1960 provided care for outpatients. There was an out-patient follow up care but this was insufficient to cope with the demand within the Kingston area as well as other outlaying areas.
Although there was an increase rate of discharges, admission rate was relatively high due to lack of adequate care for psychiatric patients outside of Bellevue. There was also the problem of long stay patients who only needed custodial care. At this time the Government became aware of the need to review the existing Mental Health Law, and that a change therefore requested help from the World Health Organization (W.H.O) with the view of appraising the existing services and families and preparing a long range programme. A W.H.O specialist assigned to prepare a National Mental Health Programme in March 1965 and after a survey made certain recommendations.