Dear Editor

UK-based Cognitive Behavioural Psychotherapist Meera Baahu was recently quoted in the local media as saying that, ‘Cultural change, promoting greater awareness and acceptance of mental health is necessary in promoting good mental health locally.’
In Guyana, those working and volunteering on the mental health landscape are not only already aware of the need for greater awareness, sensitisation and education, but are actively engaged in delivering these necessities. And so we wonder about the need to bring someone from the UK to inform of the obvious.

In the same vein we also wonder, why bring overseas ‘experts’ to spread misinformation and inaccuracies. After all, in Guyana, mental health issues are not a product of culture but of social, economic and political realities and the consequential stressors and emotional/psychological deficits. This has been and continues to be borne out by the work of The Caribbean Voice and other stakeholders, supported by primary info gathered through our many surveys and the empirical evidence garnered through our workshops, outreaches and varied interactions.

At the Third Caribbean Symposium on Suicide, held in May this year in Trinidad & Tobago, suicidologist Dr Silvia Canetto of Colorado State University, presented a paper on ‘cultural scripts of suicidal behaviour, the implicit and culturally specific blueprints for when, where and how people engage in suicidal behaviour – and how to respond to such behavior.’
However, Dr Canetto’s references are to societies that are significantly homogeneous – religious, such as Islamic states, or tribal, such as the Eskimos. In fact, as much as those scripts are ‘cultural’ they are also social/societal, because of the homogeneous nature of the societies, but the causes/triggers for suicide are same as obtain globally – poverty, abuse, alcohol, drug use, the Werther Effect, depression and other mental illnesses (Suicide Among Inuit: Results From a Large, Epidemiologically Representative Follow-Back Study in Nunavut”; Eduardo Chachamovich and others). The research and attendant literature reveal that similar findings exist for suicide in Islamic nations and among Indian farmers, for example.

Besides, Dr Canetto’s presentation made no references to heterogeneous societies such as Guyana, simply because her argumentation does not fit such mental health landscapes. In effect, it is not culture that drives suicide but overall attitudes, which become normative over time. Thus, all scripts of suicidal behaviour are social/societal, transcending all groups – cultural, religious, ethnic, gender and otherwise.

The Guyana Government is in possession of a National Mental Health Action Plan 2015-2020, drafted under the PPP and finalised under the APNU. This plan states, “Complex socio-cultural factors and the presence of a mental disorder are likely very significant, attributable risk factors.” However, “Risk factors for mental illness in Guyana are related to environmental, life- styles, biological and psychosocial factors and include, social class, gender, racial conflicts, housing, occupational risks, access to services, smoking, limited national policies, globalisation, macroeconomics, national politics and urbanisation.” This indicates that culture is used in an encompassing rather than a group-specific manner, making it clear that it is not specific cultural change itself that is required, but a change in attitudes.

Thus, instead of giving scope and credence to flying visit  ‘experts” who sow confusion and misinformation, is it not time to affirm and foster the work of those who are familiar with the realities that prevail? It is these stakeholders who know that it’s not a cultural change that is needed, but an attitudinal change at both the governmental and individual/community levels, which can only be catalyzed about by all-stakeholders collaboration, spearheaded by the government, and reaching across the nation on an ongoing basis.

The ‘Plan of Action’ itself is comprehensive and focused, but its implementation has been mostly at the level of rhetoric and especially so with respect to collaboration building. With hundreds of entities and activists involved in mental health activism and advocacy, at some level across Guyana, the government arbitrarily collaborates with a selective handful, while the rest are completely sidelined and ignored. As well there is hardly any piggybacking, or inter agency/ministerial collaboration, which would broaden outreach and scope at minimal cost.

Sincerely
The Caribbean Voice