Greene urges set up of paediatric mental health unit

Director of the Childcare and Protection Agency, Ann Greene

…says large number of children in state care come from abusive situations

By Tamica Garnett
WITH many of the children taken into state care coming from abused and or neglected situations, Director of the Childcare and Protection Agency (CPA), Ann Greene, is advocating for the establishment of a Paediatric Mental Health Unit.

Greene explained that even though every child coming to the agency is screened, and some are provided with some form of continuous counselling, is it not enough. Given the circumstances some deal with, she believes long term observation would greatly help them.
“We have some children that need to be admitted for some observation and get some good treatment. To get their behaviour observed, where you treat them, you look at their behaviour and we help programme them. We don’t have a paediatric mental health unit but I am canvassing for one to help the children,” Greene shared in a recent interview with the Guyana Chronicle.

Psychologist Wil Campbell believes that mental health of children, on the whole, is not given enough attention in Guyana.

“We have this notion that children shouldn’t have mental health problems; that it’s for adults who have issues, dealing with life and so on. But the reality is that a lot of our children are suffering, whether it’s from trauma, or from something biological, a lot of our children do have mental health issues. To have a unit that is dedicated to their mental health care is not just a great idea, it’s a necessity,” he opines.
When the situation requires it, the CPA must remove a child from a home and provide the necessary alternative accommodation. The CPA currently has approximately 700 children in its care.

Campbell, who holds a Master’s Degree in psychology, emphasized that the need is particularly great for any child in the CPA system.

“We can assume that pretty much every child passing through the CPA has to deal with some kind of trauma. I know that the CPA does not have the kind of staffing, neither in terms of numbers nor in terms of training, to deal with some of the issues that pass through there. Hence, the need for a specialist,” he noted.

“Just being removed from what they are familiar with is traumatic for adults, much less children. And they have to deal with the trauma resulting from the need to have them removed in the first place. Most likely it had to be an issue of abuse or neglect and all of those are traumatic. Some of them are abused or neglected by their parents because they have a pre-existing psychological deficit. So that would just add another layer of need for the children,” he added.

In Guyana, approximately 4,000 cases of violence against children are reported every year, while, according to reports, in 2018, the CPA reported over 4900 cases of child abuse. This is even as it is believed that approximately 90 per cent of the cases of child abuse, in Guyana, go unreported to the authorities.

“A lot of them have pain issues, effecting them emotionally and mentally. We need to really do the research. So it would be a type of metal health research unit to find out what is happening with these children. So we’re working towards having that, we’re talking with the professionals,” Greene said.

Currently, the CPA has a few psychologists on staff, and deals with the situation as best they can.

“We have two psychologists on board. It’s not enough, but we make it do until more can come later on. Every child that has been abused needs to be screened for mental health issues, and that is what we’re doing currently,” Greene says.

The country, earlier this year, got its first Child and Adolescent Psychiatrist, Dr. Jenese October. October, who has a first degree specializing in Child Psychiatry– the first local doctor to provide this specific service to Guyana–recently returned from studying in Cuba.
Greene notes that she has written October with the hope of having her work along with the agency.

It is the mandate, by law, of the CPA to look after children in need of care and protection, as well as the provision of “counselling and other services, including basic services such as shelter, food and education, for children in need of care and protection”.

“It’s challenging when we don’t really have the facilities, because there are times when we have one child who is acting up, displaying, and we might have to remove that child. We can’t let one child disruptive type of behavior affect the other children, we have to remove them for a little while out of that and seek help, because, yes, they do act up and things happen,’ Greene said.

Greene notes that at times even the staff are putting themselves in harm’s way just to look after such children.

“Many times we are victims, we are secondary victims. Our protection, too, is at risk. We go over and beyond the call of duty. We have to go more than what we should do, but we aren’t complaining, we like what we do. But then we get these unfair attacks that people don’t understand that have agendas and have their own cause that they want to promote without really coming and lend support,” she stated.

Greene feels encouraged about the Unit coming to fruition, with the news that the first batch of locally-trained psychiatrists in the University of Guyana Master’s in Psychiatry programme graduated in 2019. Another batch of students, who have pursued their Diplomas in Psychology, were also expected to be graduating. Both programmes were launched in 2017.

Mental health in Guyana has gained increased attention and focus over the years, particularly since 2014 when Guyana was declared to have the highest suicide rate in the world.

Earlier this year, Chairman of ChildLink, Kosi John, highlighted that the trauma experienced by children in Guyana is not yet understood and treated. John, at the time, was making a presentation titled “Lessons learnt from trauma stories on child abuse”, at a ChildLink forum in March.

“Trauma is the most avoided, ignored and untreated cause of human suffering,” he said, adding that it is becoming common knowledge.

In serious cases where the child poses harm to themselves and others, help is solicited from the Ministry of Public Health Mental Health Unit; however, Greene believes the children need an environment specifically tailored for them.

“We have in-care children who go to regular clinics,” Greene noted.
There are also cases of children not in state care but who are regularly visited by the agency at home to lend assistance to their parents or guardians. The agency recently had a case of a teenage young man, who the agency monitors periodically, behaving erratically in the compound of the CPA offices.

Greene explained that the child lives with his mother, who would often seek the assistance of the agency when she cannot handle the situation alone. The teen was reported missing, before turning up at the agency. He threatened the lives of the staff at the agency and was eventually taken to the hospital.

“This child, I was worried about him all weekend,” Greene shared.