More education is needed for mental...

The distribution of diagnoses varies across facilities: in outpatients facilities affective disorders are more prevalent, the majority of patients admitted to the community inpatient unit have a diagnosis of psychosis, and in mental hospitals schizophrenia and “other” diagnoses are most frequent.

Source: Assessment Instrument for Mental Health Systems WHO-AIMS). Georgetown, Guyana, 2008

There is no doubt with a shortage of trained professionals in this field, the task of simply diagnosing is a mountainous challenge to achieve by 2020.

Mental health is a vast field and often treatment boils down to judgment by the treating staff ‒ here treating staff refers to the professional trained in the area of mental health. The following pointers are to sensitise the general public on a few important markers:

1. The need for protocols and guidelines is crucial so that treating staff know and understand what they’re supposed to do and not deviate from it.

2. Protocols and guidelines hold people accountable.

3. The danger is when personal opinion kicks in, treating staff will begin to do their own thing.

4. Whenever treating staff are in doubt they will have something to fall back on.

5. Treating staff need to recognise when a patient is decompensating; they should not have to be operating in crisis mode.

6. Standing orders (a written document containing rules, policies, procedures, regulations, and orders for the conduct of patient care in various stipulated clinical situations) must be fully enforced at all times when dealing with the mentally challenged population.

7. In order to arrive at a diagnosis a thorough assessment must be done first; if a patient doesn’t have a diagnosis how do you treat them?

8. Treatment falls into three categories: (a) talking therapy, (b) medication management, and (3) a combination of both treatment types.

All psychotropic drugs have side effects, and can often produce psychosis. At times, one drug may contradict another. Blood levels should be checked to ensure therapeutic levels of the drug in the blood are achieved, especially when patients are prone to seizures. Work must be done before administering any psychotropic drug. When patients are admitted to any mental health institution and presenting in a psychotic state, the protocol is to observe the patient for 24 hours in the event they may have skipped their meds or are on street drugs. Introduction to psychotropic drugs at this early stage is detrimental to the patient.

I sincerely hope that this information is beneficial to the consumers and service providers of mental health services.

I met Adam (21) the other day; he experienced a meltdown in 2016 and passed through the outpatient psychiatric clinic. Three weeks ago he relapsed and has not been able to walk or complete hygienic functions such as brushing his teeth without assistance. Without appropriate protocols and guidelines in place, we can be creating illness.

Yours faithfully, Ingrid Goodman Executive Director Patois/Women’s Refuge