PAHO laments low budgets for high mental health challenges in Americas
HE countries that have the highest burden of mental health conditions are usually the ones that are in fact investing the least in mental health.”
This was the message brought to a Jamaican audience on Monday, by the Pan American Health Organization (PAHO) chief of Mental Health and Substance Use, Dr Renato Oliveira e Souza. Speaking at a World Mental Health Day forum hosted by the University of Technology, (Utech) Jamaica, Dr Oliveira said that prior to the pandemic the Americas had a high burden of mental health conditions.
A third of years lived with disability (YLD) among people of this hemisphere was accounted for by mental, neurological and substance use disorders and suicide.
The prevalence of common mental health disorders, such as anxiety and depression, in this hemisphere is one of the highest in the world. Yet, financial investment in mental health in the region is, on average, only around two per cent of health budget.
The forum was hosted virtually by the School of Humanities and Social Sciences, in the Faculty of Education and Liberal Studies, in partnership with the Child and Adolescent Development Programme at Utech.
The panel of speakers included Dr Ganesh Shetty, psychiatrist; Dr Kai Morgan, president of the Jamaica Psychological Society; Diahann Gordon Harrison, children’s advocate; and Jhanille Brooks, director, Jamaica Mental Health Advocacy Network.
While not presenting figures relating specifically to Jamaica, Dr Oliveira said that the majority of funds allocated for mental health goes to psychiatric hospitals, which he described as not the best intervention to address mental health for most of the population. Dr Oliveira said this was exacerbated by the low numbers of mental health workers and specialists across the region.
Adding that availability of care is insufficient to the needs within the region, he said that the novel coronavirus pandemic had created further challenges for mental health in the region.
Data collected across the region show a higher level of depression and anxiety in the general population. Dr Oliveira advised that a World Health Forum survey across various countries showed a change in emotional and mental health one year after the pandemic.
He noted that some population groups had shown particular vulnerability. These groups are migrants, ethnic minorities, persons with pre-existing mental health conditions and young people.
Front-line workers, specifically those in health care, are also exceptionally vulnerable as they face the many risks that the pandemic has brought.
A PAHO/WORLD Health Organization survey, completed two ago months in 35 countries in the Americas, examined the levels of disruption of different essential health services during the novel coronavirus pandemic, and found that in 60 per cent of countries mental health services were dislocated. The reasons included closure of mental health services in some instances and redeployment of professionals to serve in other areas of the pandemic.
Dr Oliveira said that the pandemic was not the only stressors affecting mental health in the Americas. He pointed to the relatively high homicide rates compared to other regions, high levels of interpersonal violence and the comparatively higher incidence of violence against women and children.
He indicated that PAHO and several regional countries have adopted the recommendations from the Executive Board of the World Health Organisation at its 148th session.
Key among these is that mental health must be approached from a “whole of society” perspective. Every branch of government should incorporate a mental health agenda in promoting mental health and advancing mental health care.
“We need to take this opportunity to strengthen mental health care at the country level, to build up better mental health systems, and to look into the future and as we embark on universal health coverage, that mental health is an essential element of universal health coverage for everyone.”
VILLE, Manchester — The Southern Regional Health Authority (SRHA) is reporting a sharp increase in the number of mentally ill people needing help in region.
Regional director of SRHA Michael Bent told the Jamaica Observer that there has been a more than 40 per cent increase in the number of people needing mental health care for the quarter ending September compared to earlier this year.
The SRHA covers Manchester, Clarendon and St
Elizabeth with mental health emergency response teams in each parish.
“For the last quarter we responded to 354 calls as against the prior quarter, that is April, May and June, [when] we responded to 247, so that’s about a 40-odd per cent increase… That is a steep increase in the number of responses in comparison, but we are coping,” said Bent as he responded to questions from the Observer following recent tragedies involving violence by mentally challenged people which have led to four deaths in Linstead, St Catherine and St Ann’s Bay, St Ann.
Bent said that as an essential part of their duty, mental health personnel do home visits to follow up with the mentally challenged who have not turned up for their medical appointment.
He hinted that the failure to take their medication, or incorrect dosage, sometimes contribute to mentally challenged people turning violent.
“The teams normally follow up with them. Some of them are normally given appointments and persons normally come up, so we have the teams that follow up, but like anything else, sometimes you might not be able to find them and sometimes they might not have been taking their meds as prescribed,” said Bent.
“Once they make an appointment, if they don’t turn up the team usually calls the family or sometimes actually do home visits to check on what is happening,” added Bent.
While there has been no catastrophic incident involving the mentally ill in the southern region in recent time, Wendy Freckleton, head of the Candle in the Dark Ministries, which operates a multipurpose facility to care for street people in Mandeville, said a recent incident involving emergency responders and a mentally challenged man who had a make-shift weapon had left her very disturbed.
“It is a real challenge when the mentally ill decide that they should have weapons. We have had incidents with them coming to the centre with weapons, but the good thing is whenever we ask them for it they willingly hand it over,” said Freckleton.
“Two weeks ago, we had a case where one of the mentally challenged was at the centre with a piece of steel and we had to call in the mental health department, because we were afraid that he would become violent,” added Freckleton.
She said she had to appeal to a highly placed person to get the crisis team to respond.
“When they came, they saw him and they did say that they were aware that he needs to be medicated. His medication was about two months overdue. Hence, the reason why he was behaving that way.”
Freckleton said that the man was alleged to have used the piece of steel to injure a disabled person previously.
“The piece of steel he had he used it to injure a blind man the day before yet they did not see it urgent to find him and take the weapon from him. We asked that they take him and treat him in a facility more than likely the hospital, because he was in a state that he really should have gone into an institution.
“Instead of taking him they left him at the centre [and] drove away... I don’t think that kind of response from a mental health team that should be taking care of the mentally challenged was good enough,” argued Freckleton.
“We are a charitable organisation and private people playing our part to make the work of the Mental Health Department easier and to ensure that we contribute to the safety of the wider community. Had it not been for a Candle in the Dark we would have had serious incidents with these mentally challenged persons within the business community in Mandeville.
‘’At least we provide for them a safe space that they can stay for the duration of the day. We engage them in terms of fellowship, they can have their meals, a safe place to [shower and] change their clothes. I think sometimes the authorities do not pay sufficient attention to the mentally challenged,” said Freckleton.
But Bent told the Observer that the report he received did not say that the mentally ill man had a piece of steel.
“She (Freckleton) called about a situation over there, but it was not reported that the person had any steel or anything like that. What was reported was that a mentally challenged person was at the centre and was turning on and off the gas cylinder and they had called the response team, but the response team was actually in Bellefield at that time attending to another case,” said Bent.
“I did call the [regional] psychiatrist and the team responded,” Bent added.