Mental health

Oct 14, 2008 Editorial

World Mental Health Day was commemorated, last Friday, under the theme of “Advocacy for global mental health: scaling up services through citizen advocacy and action”.

This is indubitably a most appropriate exhortation for Guyana, where “health” is associated with the physical body and mental disorders are not acknowledged as a health issue. Individuals with the latter problems are summarily dismissed as “mad people”.

However, in more enlightened jurisdictions, mental health is a broad concept that covers more than direct health issues, and includes areas such as housing, education, justice, the arts, and community participation.
It should be obvious, therefore, that to deal effectively with the problem, a broad coalition of institutions and experts, drawn from diverse fields apart from the medical field, would have to be crafted.

One mental health disorder that we have attempted to highlight in this newspaper, because it is so endemic in our country yet is studiously ignored, is “depression”.

This rather innocuous term, which suggests a rather mild mood downswing, is actually a signal that specific neuro-chemical processes in the brain are not assisting it to generate positive thoughts of well-being.

At the deepest physical level we are chemical beings, and the connection between the physical body and the mind, in which our sense of self-worth is generated, is mediated by these neuro-chemical changes in our brains.

Because of this connection, it should be of no great surprise that depression can produce severe disorders in the physical body.

For the individual, if depression is left untreated, it can generate tremendous suffering over long periods and stymie personal accomplishments.

In the aggregate, a nation of depressed citizens will never actualize that nation’s real potential and that nation will remain underdeveloped.

The spread of democracy in the modern era was spurred by the broad acceptance of the utilitarian credo of “the greatest happiness/good for the greatest number”.

It is the responsibility of modern governments to accept that the same focus that is brought to bear on “development” from an economic perspective has to be brought to bear on the interior landscape of the citizenry, where happiness in the long run is actually generated.

In any case, depression can sink even immaculately carved development plans, if the individuals who are supposed to implement those plans cannot motivate themselves to work at their optimum, because of depression.

Then there are the societal disruptions, and costs such as drug and alcohol abuse that can be precipitated by depression – not to mention the finality of suicides.

Depression, even when diagnosed, often remains untreated, because of the social stigma attached to any mental disorder on account of the aforementioned “mad people” label.

Even in mild cases, the sufferers are dismissed as being weak and “not taking charge” of their lives, which culminates in their unsuccessful careers. The individuals begin to accept the tag of “losers”.

In order to deal with this situation, it is suggested that the subject of “depression” be included in the school curriculum, starting from the primary level, just as, say, the problem of aids has been introduced in the last few years.

Early knowledge of what is behind the observed symptoms would alert suffers of whatever age group to seek early treatment. There are many students and other young people, for instance, who remain untreated and eventually succumb to suicidal urges.

The Ministry of Health, in the recent past, has acknowledged the scourge of depression and other mental health issues, and has made several attempts at getting a handle on the issue.

It is our belief, however, that a national effort is needed, because of — as we pointed out earlier — the Hydra-headed nature of the source of the problem.

Even in the medical arena, there is the need for a team effort: a psychiatrist in collaboration with that of a clinical psychologist, a social worker and an occupational therapist.

In this multi-disciplinary approach, the individual patient’s physical health — hormonal, injury, drugs and neurotransmitters factors — together with the psychological factors — personality, grooming, education, childhood etc – are dealt with.

The social worker assists the patient in traversing the myriad external stresses that confront the average Guyanese — job security, blackouts, rising food prices, banditry etc.

We urge that civil society groups be mobilised to assist the governmental initiative to deliver better mental health care to our citizenry.