PICTURE for a moment: you have a physical illness and your doctor tells you your treatment will be based on archaic, out-of-date guidelines and principles, rather than modern procedures based on international standards. You have no choice; you will be deprived of your liberty and your rights taken away if you don’t comply. Imagine the outcry, protest from the public and professions, and using all means necessary to challenge what is being done to you.
Yet, there has been a deafening silence from the public, professionals and advocates over the years, when it comes to mental health. Even the Attorney-General in a press report in Guyana Times, August 28, 2021 has reiterated that mental health prior to incarceration must be assessed. That’s the reality of psychiatric care for many in Guyana, today. You can be detained without an assessment.
To understand what is happening today, we must reflect on the inactions of past, the failure of various authorities and a lack of vision by policy makers to reform the mental health legislative framework – The Mental Health Ordinance of 1930.
Thirty years ago, The Pan American Health Organization (PAHO) and the World Health Organization’s (WHO) (1990) adopted the Declaration of Caracas. This Declaration states that national legislation must be re-drafted if necessary, so that the human and civil rights of mentally ill patients are safeguarded. This should be applied without any discrimination of any kind, to all persons who are admitted to a mental health facility. Countries should implement these principles through appropriate legislative, judicial, administrative, educational and other measures, which they shall review periodically. Thirty years later, after people with mental health conditions have been stigmatised, labelled and described as deranged and idiots. The Ordinance of 1930 is being re-drafted by [the] Guyana Government.
So what of the future? I am hopeful the re-drafted bill will include the voice of the user, people with mental ill health who have experience in using mental health services. That the re-drafted bill has:
* A charter of mental health rights to counter the discrimination, inequality and stigma prevalent in Guyanese society today;
* A mental health commission is created to supervise, monitor and carry out audits on detained mental health patients with an easily accessible appeals process.
* A safeguarding agency to protect rights, preserve safety and promote best practice in terms of assessment, treatment and rehabilitation of people with mental ill health both in hospitals, community residential services, in the public and private sectors.
* A centralised training analysis and matrix developed to ensure people are supported by staff and agencies that have the appropriate and relevant knowledge and core skills to do the job for which they are employed.
Aside from the re-drafted bill, Chapter 801 Section 96 of the Criminal Offences Act needs reform too, as it criminalises people with mental ill health who attempt suicide. It’s ironic that by seeking help you are potentially committing a crime on a Government-sponsored hotline. That is why mental health in Guyana needs root and branch reform, and the re-drafted bill is a good place to start.
The Caribbean Voice Technical Team