THE responsibilities of any government are diverse, and decisions taken by the government have real consequences for the lives of citizens. The government of Guyana has identified the health of Guyanese as being pivotal to personal happiness, community well-being, and national development, and provision of healthcare services as a major part of its responsibilities.

An unhealthy person may not be able to work, this results in a home being deprived of financial income, a community being denied the services that the sick person would have otherwise provided, and the national economy being negatively affected. Add to that the cost of caring for an ill person, and one gets a clear picture of the social and economic impact of illness.

One important aspect of overall well-being is that of mental health. According to the World Health Organisation (WHO), mental health is defined as a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. The WHO goes even further by stating that, the positive dimension of mental health is stressed in WHO’s definition of health as contained in its constitution: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
Experts have compiled a list of “feelings or behaviours” that may be early warning signs of a mental health problem:

* Eating or sleeping too much or too little

* Pulling away from people and usual activities

* Having low or no energy

* Feeling numb or like nothing matters

* Having unexplained aches and pains

* Feeling helpless or hopeless

* Smoking, drinking or using drugs more than usual

* Feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared

* Yelling or fighting with family and friends

* Experiencing severe mood swings that cause problems in relationships

* Having persistent thoughts and memories you can’t get out of your head

* Hearing voices or believing things that are not true

* Thinking of harming yourself or others

* Inability to perform daily tasks like taking care of your kids or getting to work or school

Unfortunately, the previous administration neglected this facet of healthcare to the point where Guyana citizens became known as some of the most mentally unhealthy persons in the world as evidenced by internationally recognised criteria and statistics. The primary indicator of the mental health of a territory is the suicide rate because untreated mental disorders often culminate in that fatal outcome.

A 2014 report by the WHO showed Guyana as having the highest suicide rate in the world—44.2 suicides per 100,000 deaths; four times the global average. By comparison, neighbouring Suriname had a suicide rate of 27.8 suicides per 100,000, and Venezuela’s rate was 2.6 per 100,000. In that year, Guyana was ranked first in suicides per capita worldwide. A 2003 report by the World Bank alluded to one possible cause.

The report stated that the political process in Guyana is often fought with so much time and energy that “little [is] left to undertake the many policies necessary to facilitate growth and development.” A 2001 report by the International Monetary Fund (IMF) concluded that “poor governance” [in Guyana is] a major obstacle to the reduction of absolute poverty rates, which are among the highest in the region. And numerous experts have found that poverty is a major contributor to poor mental health (which may lead to suicide).

President David Granger, cognisant that many health outcomes are irreversible – including suicide in the case of mental illness – recognises the importance of prevention. At the opening of the inaugural Health Expo at the Sophia Exhibition Centre in May 2018, His Excellency said, “Preventative care is central to universal public health coverage, to primary healthcare and the delivery of public health services.

No public health system and no national health strategy would be complete or successful without emphasising the importance of preventative care.” The President added that “prevention is central to Guyana’s national health strategy and among other things, one of the principal means of improving citizens’ physical, mental and social wellbeing.”

In the 2019 budget, government has allocated $35.9 billion to the health sector, which works out to be 11.9 per cent of the total national budget, and $2.6 billion more than last year’s allocation.

The government has repeatedly emphasised that it views mental health as a facet of human well-being that is equal in status and importance to physical health. As such, government continues to improve healthcare delivery in that area.

Most recently, it was announced that The National Psychiatric Hospital located at Fort Canje, Berbice, underwent numerous upgrades last year. The hospital also saw major developments which positively impacted the lives of patients. A nutritionist was employed, a modern switchboard was installed, several abandoned buildings in the compound were demolished, and there are plans to resuscitate the playfield located in the compound, and start a poultry farm as a form of therapy for the patients.

Evidently, government recognises that all Guyanese are equal, and all citizens are entitled to a good life. No person should be shunned, stigmatised, or ignored; instead, it is the responsibility of government to ensure that those who need assistance, including healthcare, receive such assistance.