JAMAICA'S MENTAL health services have come a long way, but still must go further. Daily, we are confronted with issues indicating that the mental and emotional health of our population is at risk. Some of the issues include the homeless, mentally ill, domestic and other forms of violence, homicide and suicide, post-traumatic stress, problems of children and adolescents, including abuse, lack of parenting skills and others.
To a certain extent, a lot of the focus has been on the "most obvious" of the mental health problems that is, the schizophrenic and other psychotic disorders. At this crucial time of our development as a country and with the issues threatening our mental health, those who have been entrusted with the task of organising and providing mental health services are constantly seeking to do so in the best way possible. All the stakeholders must be heard in this process.
Some of the key elements which will be addressed as we seek to meet the needs of the population include:
Integration of mental health care into primary health care. This will involve the continued training of primary health care workers for example, general practitioners and nurse practitioners to diagnose and treat depression, anxiety, stress-related disorders and other common problems which often co-exist with medical problems.
The need to have counselling and psychotherapy services more accessible and available to those in need at the primary care level.
The need for public education on mental health issues, how to access services and the destigmatisation of mental illness.
Assertive Community Treatment for people with chronic and severe mental illness. This involves continuous individual support, mainly in the community, psychosocial and vocational rehabilitation.
Improvement of the psychiatric emergency services. This will mean ensuring a clear access to this service in case of a mental health crisis - ranging from telephone access to face-to-face evaluation and treatment.
Adequate inpatient care. The emphasis will be on short-term hospitalisation with adequate and appropriate pharmacological and other treatment and also the return to community.
Housing/community supports. It is important to recognise that many people with severe mental illness cannot live independently and will need supervised housing (and other community supports, for example, supported employment) in order to remain well.
Family, self-help and the role of advocacy and user/consumer initiatives. The role of advocacy groups, self help and family groups has proven to be of utmost importance in mental health. A lot has been achieved by these groups internationally in terms of ensuring that the stated goals are being achieved; increasing public awareness and education and public and private funding of services, quality assurance and so on.
It is a very interesting and dynamic process that is presently in place and one that needs the support of all Jamaicans.
Dr. Maureen Irons-Morgan, Senior Medical Officer, Bellevue Hospital.
