patients is threatened by budget cutbacks.

And Dr. Isaac Ewusi-Mensah, who specialises in treatment of the mentally handicapped, has also filed a complaint with the Human Rights Commission that the Hospitals Board's decision to not renew his contract is discrimination.

Ghanaian Dr. Ewusi-Mensah is one of five staff psychistrists at the Hospital.

In early June, he was informed the Board would not renew his three-year contract because "of financial circumstances...'' He was the only one to not win renewal of his contract, which expires in April.

Dr. Ewusi-Mensah wrote a memorandum to the Hospitals Board arguing the decision to eliminate a designated psychiatrist for the Mentally Handicapped Services was "gravely flawed and short-sighted.'' Bermuda, he said, needed a specialist working with the mentally handicapped.

News of the cutback prompted staff at St. Brendan's Mental Handicap Unit to petition the Board to maintain the designated psychiatrist.

There are currently 250 registered individuals with mental handicaps -- a 1-200 ratio that gives Bermuda one of the highest per capita levels in the world.

Dr. Ewusi-Mensah said about a third of the beds at St. Brendan's are occupied by people with mental handicaps.

"Many of them have been in hospital literally for decades,'' he said in his memorandum.

"About two thirds have concurrent psychiatric disorder and are on medication.

Others develop psychiatric conditions due to a prolonged period of institutionalisation.

"A designated psychiatrist with experience in mental handicap ought to be responsible for their care regularly, but not on an ad hoc basis.

"The care of the mentally handicapped is time consuming and labour intensive, where morale and continuity of service matter.

"It is not enough, indeed it could be even detrimental to the clients' well-being and quality of life if their care is left to the vagaries of financial constraints, or worse still on an ad hoc clinical intervention by people who may not have the expertise nor the interests in looking after them.'' Last night, Hospitals executive director Mr. Hume Martin issued a statement saying the Board had made the difficult decision to eliminate the designated psychiatrist position after careful consideration and "in response to the continuing need to operate both hospitals as efficiently as possible.

"The decision will reduce the Board's complement of psychiatrists from five to four -- the same level employed in early 1989.

"Responsibility for the mental handicapped services will be assigned to the remaining four psychiatrists.

"The Board is completely confident that it can continue to maintain the high standards of service for the mentally handicapped population with one fewer psychiatrist.'' Dr. Ewusi-Mensah's complaint to the Human Rights Commission alleges that Mr.

Martin "misinformed and misled'' the Board that there was no longer a need for a designated psychiatrist.

He also alleged that Chief of Psychiatry Dr. Richard Lament had been in a conflict of interest in that he was asked with others to decide whose contract should not be renewed. The conflict occurred because his own contract was involved in decision.

Dr. Ewusi-Mensah is the longest serving consultant psychiatrist at the Hospital having served there since 1989. His first three-year contract renewed in 1992.

One of the grounds Dr. Ewusi-Mensah argues in his brief to the Commission is that the decision to cut his position was not budget-related after all.

Mr. Martin's statement that the job cut was due to budget cuts stands in contrast to a recent decision not to proceed with the elimination of one of two resident psychiatists' posts "because the economy had improved.'' As the only psychiatrist on staff with "previous experience'' with the mentally handicapped, he said when contacted by The Royal Gazette that "the issue is the mentally handicapped will be shortchanged without a specialist with experience to care for them.'' Last night, Mr. Martin said the Board "regrets the decision by Dr.

Ewusi-Mensah to undermine the work of the Human Rights Commission by discussing the matter with the media prior to the Board having an opportunity to present its case to the Commission.