Sole mental healthcare provider faces shortage of drugs

Mental health treatment and care in the country is in serious trouble because the Laloki Psychiatric Hospital –– PNG’s only Level 6 hospital  that takes care of patients with mental issues ­­­­–– is running low on drugs.

Acting chief executive officer, Dr Esorom Daoni, confirmed the dire situation, adding there is no money to buy fresh medicine and fix the deteriorating facilities.    

Currently there are 54 inpatients, seven female and 47 males and unlike patients at normal hospitals, Laloki is a specialised facility that administer specialised drugs to these patients

The hospital’s Director for Medical Services Dr Ludwig Nanawar, the number of admissions was increasing due to social issues like the rising cost of living, drugs and alcohol abuse, marital issues and young patients coming from broken families such as divorce or separation of parents.

“We receive those individuals who are severely ill who cannot be managed in primary care and provincial hospitals,” he said.

The hospital gets its medicine supply from the national drug catalogue, at the Area Medical Store but buy those that are not in the catalogue from outside sources.

Dr Nanawar said the nurses had to observe patients and administer whatever limited supplies that was in stock to the patients.

“We have written prescriptions for some of the patients who have been discharged, hoping the families can buy those medicines at the pharmacies, if they can afford them.

“In the country, we have very limited antipsychotics available and some of them are quite effective while some are not, so when a patient does not improve, there are other options.

We are trying to look at new drugs in the national drug catalogue, however, those are yet to come through the Area Medical Store and I don’t know how soon we will be getting these new drugs for patients to recover quickly and return to work, school and family life,” he said.

He admitted that they do have a serious issue with medicine supply and a lot of times when there is no medicine available, they buy these drugs by using hospital funds from private pharmacies like City Pharmacy and others.

Dr Daoni the hospital’s standard of service had dropped with its bank account  holding only K2600, a stark reflection of its dire financial state.

Dr Daoni said the decline of the hospital began after the Mental Health Act 2015 was enacted.

“The intention of the act was noble, but its implementation was flawed,” he stated.

He described the law as “badly written and draconian”, adding that it was not aligned with other key health legislation such as the National Health Administration Act of 1997 or the Public Hospital Administration Act of 1994.

According to Dr Daoni, the establishment of the Social Change and Mental Health Directorate under the act diverted focus and resources away from Laloki Psychiatric Hospital.

“The hospital has been overlooked in terms of funding and infrastructure maintenance. Most of the buildings are now condemned,” he said.

A recent hospital assessment conducted in October 2024 confirmed the hospital is functioning well below the required standards, with a total score of 26%—far below the national benchmark of 60%.

Key areas such as patient care, leadership, human resources, and environment standards were rated unsatisfactory.

Dr Daoni identified several urgent actions required to restore the hospital to Level 6 status.

These include developing governance frameworks, service improvement plans, and overhauling the hospital’s infrastructure while constructing new facilities.

“The absence of a Mental Health Board for over 15 months has further compounded the challenges. Leadership and operational management have been severely affected,” he said.

Investigations into mismanagement at the hospital and the directorate are also underway, with key figures, including the acting director of the Social Change and Mental Health Directorate, suspended to facilitate inquiries.

Dr Daoni emphasised the urgency of the situation, adding; “We need a major restructure of the hospital to increase the workforce, improve infrastructure, and secure funding,”

The hospital is awaiting the release of K1 million in funding approved by the Department of Health, pending clearance by the Finance Department since November 2024.