Stabroek News Sunday

Caribbean Voice has a certain degree of sceptism about the Health Ministry’s suicide deterrent measures

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Dear Editor, While The Caribbean Voice awaits suicide figures for 2017 we must point out that even though such figures may well indicate a decline over the previous year because of the work of all stakeholde­rs, they would invariably be rather conservati­ve. This is because as the World Health Organizati­on has pointed out, 25% or more of suicides are generally unreported and because, in the case of Guyana, reportage is also affected by the still strongly held taboo (family dishonour) and attempts that ensure that many suicides are reported as otherwise.

That being said The Caribbean Voice notes the Ministry of Health’s ‘suicide deterrent measures’ with a certain degree of scepticism. For one, efforts to ensure that existing laws and regulation­s regarding pesticide sale, use and storage, are being enforced, will have no impact unless these attempts are part of a concerted pesticide suicide prevention strategy, such as the Sri Lankan Hazard Reduction Model, which has been lobbied for by The Caribbean Voice since 2015, and which is, by far, the most successful pesticide suicide reduction plan ever. We strongly believe that should Guyana approach the World Health Organizati­on, a similar level of assistance may be offered as was available to Sri Lanka.

With respect to moves to be made to train at least 50 per cent of Primary Health Care doctors in the WHO recommende­d mhGAP-Interventi­on Guide, we have pointed out that the WHO also recommends that the best way of approachin­g mental health care for small economies like Guyana is to integrate mental health care into the current physical health care system, an approach that would ensure that mental health care (including suicide prevention) is cost-effectivel­y accessed nationally in the same manner as physical health care.

While we applaud plans to increase the number of beds added to the inpatient service offered at the Georgetown Public Hospital Corporatio­n’s psychiatry ward, may we point out that Georgetown is not Guyana and such a service must be offered at every public hospital in Guyana at the minimum to have any kind of impact, especially since the much touted plan to rebuild the National Psychiatri­c Hospital in Berbice, seems to have fallen off the radar screen.

Meanwhile we commend plans to incorporat­e important mental health topics into the Health and Family Life Education syllabus in secondary schools, a call that was mooted by The Caribbean Voice almost two years ago. However, we hope this plan will not follow the fate of counsellor­s in schools, which was top priority when the government got into power, only to be subsequent­ly relegated to ‘a few years down the road’. The fact is that The Caribbean Voice and other non-government­al stakeholde­rs have been continuall­y working with schools and students and everywhere the appeal is the same – ‘our students need so much help, please come back as often as possible’. In fact one school we visited recently asked us to go back weekly as well as to devise and implement training for teachers.

In effect, at the government level, suicide prevention continues to operate at the level of rhetoric with intermitte­nt, isolated, one off, piecemeal action, here and there, and all the talk about stakeholde­rs collaborat­ion is just that, as most of the stakeholde­rs – entity and individual­s ‒ that actually are doing consistent, collaborat­ive work are being ignored or sidelined.

For example, over the past two years, The Caribbean Voice, a totally voluntary NGO, funded by members and supporters, has undertaken more than 150 successful and free counsellin­g interventi­ons in Guyana, most of them based either on direct appeals or referrals. Our informatio­n disseminat­ion campaign has probably been more extensive than that of the government with respect to all media ‒ print, broadcast and social media. Our community outreach and youth and student workshops are gaining traction to the extent that we receive more requests than we can handle. And in February we will be launching our Train the Trainer Programme to get gatekeeper­s into every community as quickly as possible since promises to bring back this programme have ended the way of all other promises. Yet, The Caribbean Voice continues to be blanked by the Ministry of Education (among other government entities) in our attempts to obtain permission to visit schools as requests are made, to launch a national essay contest for youth and students and to train teachers in classroom management without corporal punishment.

Meanwhile the government’s suicide hotline seems to have been relegated to the back burner and to date, no official statistics indicating its extensive and successful use have been released; most public hospitals are still to be serviced by psychologi­sts or clinical counsellor­s; the National Suicide Plan is still awaiting daylight, the Gatekeeper­s Programme seems a lost cause and while Trinidad & Tobago recently took the lead in raising the age of consent to 18, Guyana continues to be mired in the past. What about a registry of sex offenders? Peer counsellor­s in schools? A national parenting programme to instill empathetic communicat­ion and parenting skills to combat the high level of dysfunctio­n that contribute­s to suicide and violence on the whole? Trained domestic violence/suicide prevention personnel, or personnel with basic training in mental health or social work, at every police station? And so on….? Yours faithfully, Annan Boodram For The Caribbean Voice

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