OVER the years, the issue of mental health in Guyana has mostly been dealt with from a reactionary standpoint — after certain tragedies would have happened to emphasise the need for better services and facilities.There is an evident correlation between a country’s mental health and its economic growth, as mental health can impact poverty through loss of jobs due to illness, among other factors; while a positive impact on health can see finances destined for health being diverted to other sectors.

Despite the evident need for these facilities to be available, as well as persons trained in the area of mental health, there has been both ill-managed and inadequate allocation of resources to provide for mental health issues.

Several factors are at play in the lax struggle against mental illness. These factors range from political unwillingness to a culture of self-reliance and stigma; and it will take several interrelated factors to help hasten the process of tightening the struggle against mental illness.

Currently, there are five psychiatrists in the country’s public health sector, although there are several psychologists; and while they offer counselling, their limited numbers do not enable much change, especially since they are almost all located in Georgetown.

There were some murmurings about a possible Master’s in Psychiatry programme being implemented and conducted through the University of Guyana, but whether or not the plan is still in the works remains unknown. Such a programme would, however, be beneficial, as it would serve to increase capacity of the public health sector in tackling mental health and those suffering from it.

Public Health Minister Dr. George Norton has also stated that a Mental Health Institute (MHI) would be introduced to the country, while internal and external improvements are being made at the National Psychiatric Hospital in Berbice.

On the surface, there seems to be a lot of plans to address mental health, but with the country having the highest suicide rates in the world, questions need to be asked regarding the sufficiency and adequacy of these plans, and how soon these changes will be seen. Mental health has, for too long, been placed on the back burner, resulting in minimal expenditure and general neglect of the sector.

One step which needs to be taken soon is to carry out one of the World Health Organization’s suggestions to decentralise mental health care and integrate it into primary health care. This would see tasks being carried out by general workers rather than by specialists, as they are in short supply, while the need for their services is great.

Better systems alone, however, cannot eradicate the problem, and clinical settings should not be seen as an end-all achievement. Familial and societal support can play a large role in treatment, as will education on the need for acceptance and inclusion of afflicted persons, so as to ensure they are not being ostracised.

One of the major hurdles which need to be overcome is the stigma associated with those who suffer from some kind of mental health issue. Guyana being a superstitious country, its citizens often view mental illness as something due to demon possession or the manifestation of Obeah having been worked on the sufferer. That aside, there is the belief that the mental health sufferer is just crazy and needs to be locked away and forgotten. This stigma often results in many persons concealing their symptoms if they can, to preserve their “normalcy” in both their family structure and society; as lack of understanding, personal biases and intolerance hinder them from seeking treatment.

This concealment often results in the person not getting treatment as early as they should; and consequently their condition — when they finally seek treatment -– is usually too advanced for them to ever reclaim a life of normalcy. Too often, those suffering from mental health issues — such as depression, stress and anxiety — see suicide as an option; as mental health, besides being heavily stigmatised, is not understood.

There has, for too long, been a general attitude of sloth in the mental health sector; and while many politicians have, over the years, made pronouncements on their plans to address mental health, actions invariably fall short and lack proper execution.

While the intentions behind the National Mental Health Strategy 2015/ 2020 can be seen as good, execution has mostly not been properly done.