Dear Editor
THE Stabroek News editorial of March 2nd repeated that inaccurate 44% suicide rate which, unlike other rates for that or any other year, had the globally unreported 25% factored in, according to the WHO, and was thus an anomaly, as indicated below.

Thus that BBC video that was referenced in the editorial contains inaccurate statistics in addition to no in depth analysis, wrong information about suicide in Guyana, and little mention about the successes in suicide prevention over the years as a result of the hard work of NGOs and activists. As well, the following were not interviewed: suicide survivors; NGOs that do substantive suicide prevention work; counsellors who handle suicidal and suicide survivor cases. And no suicide hotspots were visited.

Also, the BBC’s assertion that Guyanese joke about and trivialize suicide is awfully untrue. In fact, having done work in six of the ten regions in Guyana over the past four years, The Caribbean Voice (TCV) can testify that Guyanese take suicide very seriously. A survey commissioned by TCV in 2016 found that 96% of Guyanese were willing to engage in suicide prevention if provided with the requisite training.

It should also be noted that Guyana is not unique with respect to more female suicide attempts as against more male suicide deaths; this is the global reality, known as the gender paradox in suicide. Incidentally, we once again urge all media to not use the word ‘commit’ when referring to suicide because of its negative connotations. Experts and activists globally suggest ‘died/death by suicide’, ‘suicide victims’ or ‘suicide deaths’ instead.

To bring about significant reduction in suicide, the government, per the WHO recommendation for small economies, needs to fully integrate mental health care into the physical health care system with psychologists in all public hospitals, with easily accessible psychiatric wards in all public hospitals, and periodic visits by psychologists to all satellite clinics and community health centres.

As well, all medical personnel throughout the current health care system should be trained, with respect to the mhGAP, WHO’s action plan to scale up services for mental, neurological and substance use disorders for countries, especially with low and lower middle incomes. And a full module on mental health should be included in the nurses training program so that they can become part of the integration process from the start of their career.

Also, the 30 counsellors who graduated late last year from the American University of Peace Studies should be deployed throughout the school and/or health care system while teachers should be facilitated to undertake studies for the UG Diploma in Psychology. Furthermore, basic mental health training should be included in all training programmes, especially the holistic program to replace HEYS. Also needed is an adaption of the Sri Lankan Model of Hazard Reduction to tackle pesticide suicide.

According to WHO, “an important concept in primary health care is that health activities should develop horizontally to involve other sectors working within the community…inter-sectoral collaboration, involving governmental and non-governmental organizations is important in all areas of health.” In effect, a return of the Gatekeepers’ Program, various versions of which have been highly successful in Sri Lanka, Zimbabwe, Uganda and elsewhere.

There is also need for updated legislation to overhaul the ossified 1930 Mental Health Ordinance so that a range of deficits outlined by WHO are addressed and the legislation informed by the latest advances in treatment for mental health. To avoid political footballing, we suggest that this be done on a bipartisan basis. We have already seen the effects of partisan politics when the motion to decriminalize attempted suicide was voted down by the government, even though they supported it in principle. Clearly, a bipartisan approach is also necessary to take this law off the books.

The bottom line is that there must be political will to tackle suicide in particular and mental health in general. Collaboration must move beyond words to concerted action and regardless of their outlook, political affiliation or ideology, all stakeholders willing and able to make a contribution must be included in a national effort to deal with suicide and other mental health issues. There are hundreds of NGOs, FBOs and CBOs willing to be involved. We know because we have interacted and collaborated with many of them through our outreaches, training and lobbying efforts and the National Anti-Violence Candlelight Vigil, held on September 10 each year.

Besides, as evidenced by various TCV polls since 2014:
–  92% of respondents believed suicide is preventable,
–  75% felt that the government is not doing enough to address suicide.
–  69% felt that the government is not doing enough to address domestic abuse.
–  79% support the call for the age of consent to be raised from 16 to 18.
–  86% believe that sexual exploitation against young people is on the rise and that government needs to take action to deter such occurrences.
–  80% support the call for a sex registry for offenders.
In short, Guyanese not only want more from the government with respect to mental health, but they are willing to be partners in mental health care and to support measures not yet on stream but that would help to make a difference.

Regards
Annan Boodram
T h e Caribbean Voice