The Mental Health Unit of the Ministry of Public Health is committed to community engagement as part of its national suicide prevention strategy and experts believe that since mental health problems originate in the community, the solution is also to be found there.
Engaging reporters at a media brown bag event held on Friday at the Pan-American Health Organisation (PAHO) office in the city, Dr Jorge Balseiro, specialist consultant of Psychiatry at the Georgetown Public Hospital, said “more than 90% of the mental health problems are born in the community and thus the solution is in the community. Psychiatry hospital is not the way to solve psychiatry problems. We have [to] develop [a] mental health action plan to work in the community to prepare persons in psychiatric care in the community and imbue mental health into primary health care.”
Mental health issues have been linked by studies to 60% of suicide attempts in Guyana. This statistic is one of several generated from a study into suicide conducted in Guyana. The study titled ‘A Profile of Suicidal Behaviour in Guyana: A Retrospective Study 2010 to 2012’ has deduced from its examination of 899 cases that the person who attempts or completes suicide in Guyana most often fits a particular profile.
Of the 555 successful suicide cases examined, the largest percentage were Indian males. While women in Guyana were three times more likely to attempt suicide, men were four times more likely to succeed.
The research also revealed that while suicide occurred in a broad spectrum of ages, suicide attempts are most likely to occur between the age range of 10-29 years.
PAHO/WHO country representative Dr William Adu-Krow said that suicide occurs across a spectrum which moves through four stages: ideation, planning, attempt and completion.
He acknowledged that it takes very little effort to plan a suicide in Guyana and therefore, suicide should be addressed from the level of ideation which can only be done from the level of the community. The health professionals present expressed the belief that community support systems and religious groups must all play roles to stop persons at the level of ideation.
It was stated that research suggests a direct correlation between certain religions and suicide in Guyana.
Of the 344 individuals who attempted suicide in the years under review, 40% practiced the Hindu faith while 30% identified as Pentecostal Christians. These figures suggest that one way of addressing this issue is through religious leaders.
Balseiro noted that “most people in Guyana belong to a religion, everybody goes to church every Sunday thus it is a good way to get the people to talk face-to-face about this problem.”
Psychiatrist Dr Bhiro Harry noted that the Mental Health Unit is currently utilizing though the suicide helpline, a community based counselling program. He spoke of the “cops and faith” approach being used. This approach, he said, is being used in five different areas, one of which is the suicide helpline.
He explained that when persons contact the helpline, it triggers a response in the area they are from. If their situation involves physical abuse, then police become involved but for counselling services, a network of pastor counsellors exists within the country. These persons who are mostly from the Christian faith have been trained by the Mental Health Unit. Efforts are also being made to train religious leaders from the Hindu faith.
Dr Harry also addressed the lack of demonstrative love in homes. He said that several young people become involved in unsuitable relationships because that partner is the first person to tell them that they love them. A lack of communication in the home and of healthy expressions of love often lead to the development of mental problems and conflictual relationships.
“In Guyana our expressions of love are violent,” he asserted.
Sociologist John O’Conner noted that while it is easy to focus on the event of the suicide, it must be examined at a deeper level.
“One plus one equals two no matter how many times you add it together,” he said, adding that the Mental Health Unit may rescue people only to have them return to the same circumstances and then to the Unit sooner or later. In order to institute permanent changes, he believes that deeper sociological problems must be addressed.
“We can’t put a woman back into an abusive relationship. We need to put in groundwork so that a year down the road, she is not in the same situation. Suicide is a difficult problem to address…it takes major changes in the society…it’s going to be a long, hard road. It is a result of many things in our society. We will have to work at them slowly and with dollars,” he asserted.
Among the ideas raised is the effort to train teachers in the identification of students who are exposed to risk factors for suicide and the inclusion of a mental health component in all existing curricula.
The mental health professionals also stressed that responsible media reporting is essential to the prevention of suicide in Guyana. They referenced the inclusion of graphic details in reports about suicide and suicide attempts as well as the sensationalisation and speculation which is involved in the reporting of suicide cases.
