COVID-19 demands action on mental health
IT ISN’T yet part of the COVID-19 discourse, but mental -health issues are likely to emerge as significant side effects of the new disease, requiring the attention of public-health policymakers. For anxieties around COVID-19 apart, Jamaica already has a high incidence of mental-health problems.
In a widely quoted document last year, the World Health Organization (WHO) reported that one in five – 20 per cent – of persons of who live in areas of conflict suffered from mental health problems, significantly higher than the six per cent reported three years earlier.
Jamaica isn’t officially a war zone, but as we observed at the time of the report, with more than 1,000 murders annually and a homicide rate upwards of 45 per 100,000, the murder rate, according to social anthropologist Michael Gayle, is higher than what generally characterises countries in low-grade civil war.
A decade ago, Fred Hickling, professor emeritus of the ,Department of Psychiatry at The University of the West Indies (UWI), Mona and psychologist Vanessa Paisley reported that up to 40 per cent of Jamaicans, between three and six times the global norm, exhibited personality disorders. And in 2016, responding in this newspaper to the World Bank’s move to bring mental health – and its cost to societies when they fail to deal with it – to the centre of global economic discourse, Professor Hickling argued that when a broad range of conditions, such as personality disorders, psychosis, and dementia are taken into account, “the prevalence of mental illness in our little island would exceed 70 per cent”.
SHOW SYMPTOMS OF STRESS
Whatever the truth of that data, the prevalence of mental illnesses in Jamaica can hardly escape exacerbation by COVID-19, which has already taken over 197,000 lives around the world. The virus that causes the disease has no vaccine. Its spread is best contained by persons keeping a distance from each other. In pursuing this goal many countries have shut down large swathes of their economies, putting hundreds of millions of people out of work. In Jamaica, for instance, the critical tourism industry has collapsed, with a knock-on effect on a wide range of industries.
Additionally, around the world, including in Jamaica, whole cities, and regions, have been shut off and vulnerable people isolated or quarantined. People, health professionals say, have begun to show symptoms of the stress of major, abrupt,and possibly long-term, changes to their lives.
Among the most poignant images from the recent shambolic first day-off from the lockdown of the parish of St Catherine was of a middle-age woman in tears before television cameras, lamenting her inability to buy basic food supplies for a few days. She had too little time and the crowds were too thick.
Experts have warned of the isolation felt by many, especially the elderly, who are quarantined. There are also the anxieties that will affect the tens of thousands of Jamaicans who live on the margins and have to hustle daily for the cost of that day’s meal. Others will worry about the future of their jobs.
Mental health hasn’t, in recent decades, been at the forefront of public health policy, notwithstanding recent campaigns against the discrimination and stigma suffered by persons with mental illnesses. Two years ago, a government-appointed task force, led by psychiatrist Earl Wright, concluded that the island’s “community mental-health services are severely under-resourced and unable to cope with the many needs, including early diagnosis and treatment”. It proposed major reforms to the management of mental illness, including new legislation on the matter. COVID-19 adds urgency to the need for action by the Government on Dr Wright’s report.