Mental Health = National Wealth. None should be left out in National Strategy

Oct 17, 2015 Letters

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Dear Editor,
Like a stain that remains visibly evident on a fabric despite multiple washes and the painstaking utilization of stain removers, so looms the issue of suicide in Guyana.  Yes, Guyana has the highest suicide rate in the Americas and the highest in the world according to the World Health Organization. The Kaieteur News October 15, 2015, reported the launching by the Guyana Foundation with an aim to prepare a National Mental Health Strategy. While I sincerely laud the efforts of this organization and others such as the NGO, permit me, nevertheless, to address some areas of concern, and ones which I feel would in the long run hinder or halt progress and long awaited changes. With no malice or rancor aforethought, let us not forget that Mr. George Norton, current Public Health Minister did express his dismay, as he attempted to fathom how it was possible for the public health sector to not have a functioning Mental Health Unit all along (Kaieteur News, August 9, 2015). Effective mental health translates into National wealth.  To further compound this  perplexing state of mental affairs, previous newspaper reports on the said matter also pointed out the fact that nothing seemed to have been done previously, despite promises made by high ranking officials in the previous government.
The 18th century English poet Alexander Pope in Essays on Man and Other Poems states thus: What reason weaves, by passion is undone. Every suicide, in addition to being an individual tragedy, is also a major issue and a terrible loss to society. The devastating impact of suicide, economically, spiritually and psychologically for all those affected cannot be lightly overlooked or underestimated. Now for the requested elucidation of my expressed concern. It was stated that this recently-concluded mental health workshop had a dozen or so participants, including educators, social workers and even rice farmers. Good show! But are there not some vitally important primary stakeholders whose titles and seeming presence were noticeably absent from the mentioned line up? Were they invited and ultimately became a no-show? Or, at this juncture, are they classified or considered as non-essentials— not vital to the current plan at hand?
What of the church leaders (more integration with religion is essential in combating suicide), youth leaders (young people are made to understand that membership and participation in interactive social groups can help with the suicide problem), community leaders/ representatives (there are many things that can be done in our communities, outside hospital and care settings, to help those who think suicide is the only option), employers, parents,  peers, representatives of the justice system, health system/ mental health system, pharmacists, police (first point of contact), and of course representatives of the media and media outlets, especially  if we are going to talk about mental health awareness. They can prove to be an invaluable means of information transmission about sources of help and support when contemplating suicide (Suicide Hotline).
Depression has been identified as one of the most important risk factors for suicide, thus across the population the early identification and prompt effective treatment of depression has a major role in preventing suicide. Suicide can have devastating effects on a community, and the loss of a loved one can have a profound and sometimes devastating impact on those left behind, often called suicide survivors.  Life is not easy for suicide survivors, as sometimes they also find that following the loss, their relationship with other people changed, as they struggle with the accompanying stigma often placed on suicide. Suicide may engender feelings of guilt, blame and failure all of which may lead to altered family relationships. There has been a recent emergence of evidence that post-suicide interventions at community level can help to prevent copycat and suicide clusters, hence the need for inclusion. The factors leading to someone taking their own life are extremely complex, hence no one organization is in a position to directly influence them all. Studies that attempted to find answers to a number of questions explaining suicide in Guyana have concluded that there is no one attributable factor , social or psychological and as a consequence further empirical investigations are required.
Methinks that imperative and equally vital to this national mental health strategy is a careful revision and transformation of the mental health system, starting from the home and making its way to the schools. Most people who take their own lives have not been in touch with mental health services. There should be a greater prominence of measures to support families worried about a loved one being at risk, and those coping with the aftermath of a suicide, as they themselves are at increased risk of mental health and emotional problems and may be at higher risk of suicide themselves. There should be a tailored approach to their mental health if their risk is to be reduced.  No mention was made of parents receiving training and support programs to help them be aware or recognize the warning signs of suicide. Incidentally , the founder of the Guyana Foundation emphasized that the entire nation needs to be on the lookout for each other,  and that mental health counselling and assistance will be brought to every single individual who is feeling vulnerable. These expressed desires are seemingly better expressed than exercised.  Attitudinal changes and heightened tolerance levels of all Guyanese are imperative, especially if the inclusion of every individual, (no allusion to sexual orientation) as mentioned by the founder refers to homosexuals, lesbians, transgendered or bisexuals. To coin yet another Guyanese phrase – That’s a different story”.  Horses of different colours!
One of the chief facilitators at the workshop was Guyanese- Canadian mental health professional Dr. LatchminNarain, who is a certified psychometrician.  It would be interesting to know if psychometrics would eventually form part of the National Mental Health Strategy.  As a fully qualified member of the mental health profession, I daresay that while it is an essential suicide screening and assessment tool it is transcendent for the immediate, particularly where it pertains to mental health and the launching of the National Mental Health Strategy that Guyana functions within the well- known and well proven adage: Creep before you can walk.
Yvonne Sam   

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