Guyana will soon be offering differentiated care for persons dealing with mental health conditions.
This is according to Dr Bhiro Harry, Head of the Ministry of Public Health’s Mental Health Unit. Dr Harry was speaking at the “Mental Health and Wellness” public engagement which was held at the National Library on Friday to commemorate World Mental Health Day.
Mental Health Day was observed under the theme “Dignity in Mental Health.”
Dr Harry in his presentation noted that Mental Health Care in Guyana has come a long way in the last 30 years but it still has far to go. He explained that as part of its National Mental Health Strategy, the Ministry of Public Health will be “transferring much of [its] efforts from institutional to community care.”
This approach will be realised through the utilization of existing primary health care services and the construction of a National Psychosocial Rehabilitation Centre in Central Georgetown.
Harry said that presently the National Psychiatric Hospital (NPH) at Canje, Berbice has 200 functional beds which are mostly occupied by persons who do not need round-the-clock care.
“They do not need to be there but we do not have sufficient people on the ground trying to find homes for these patients,” he lamented.
Harry also lamented the limited number of doctors and nurses trained to provide care for mental health patients which limits the ability to provide differentiated care.
“We currently have three psychiatrists based at the Georgetown Hospital and three at the national psychiatric hospital, one psychologist and limited number of nurses,” Harry explained, adding that at the NPH patients are separated based solely on gender, male and female. As a result “all different types of illnesses are mixed, those who are very unwell such as those who are psychotic and aggressive are housed with those who are not psychotic.”
At the proposed National Psychosocial Rehabilitation Centre patients will be treated in several strata. It is expected that the centre will provide psychogeriatric services, specialized rehabilitation services for substance abusers as well as direct mental health care through an emergency unit, crisis centre and supported community care
Speaking with Stabroek News at the engagement, PAHO/WHO representative Dr William Adu-Krow noted that he believes “there is a lot to be done” to make sure that persons suffering from mental health issues are treated with dignity. He specifically called for the stigma attached to mental health issues be addressed.
He explained that he had recently learned that the National Psychiatric Hospital was referred to as the “Berbice mad house” a phrase which does not acknowledge the rights of those housed there.
“We see the way mental health patients are treated they used to call it Berbice mad house. Mental health issues are health conditions. There is no dignity in referring to a place of care as a mad house.”
He stressed that mental health follows a spectrum. “If you are sad it is a mental health issue, if you are overly happy it is a mental health situation, if you are angry with your husband, boyfriend, wife or child it is a mental health situation. At some point we all become mental and if we don’t have dignity in mental health it is going to affect all of us,” Adu-Krow explained.
His comments reinforce the ideas expressed by the UN Secretary General Ban Ki-moon in his statement where he notes that “many people around the world living with mental and psychosocial disabilities continue to face discrimination, stigmatization as well as physical, sexual and emotional abuse and neglect.”
He added that prospects of recovery are also affected by a “lack of qualified health professionals, use of coercion in treatment, and imprisonment in isolated mental and social health facilities” and that this “further hinders their basic human rights and their prospects of recovery,” the secretary general called for policies and laws to ensure everyone is able to enjoy the dignity and rights with which there are born.
He stressed that “services need to promote this dignity, and communities need to support it.”
Last month, Minister of Public Health Dr George Norton told Stabroek News he is still extremely disappointed over the condition he found the psychiatric hospital in when he took office four months ago and also noted that he found “practically nobody in charge” at the institution.
The minister said when the new government took office, the hospital was being managed by the Berbice Regional Health Authority which was headed by PPP/C parliamentarian Dr Vishwa Mahadeo. The authority, which the minister described as illegal, has since been disbanded. Norton said part of the reason for the authority being disbanded was “because it was not doing anything.”
The 2015-2020 National Health Strategy of Guyana according to Dr Harry will make sure that every regional hospital has a nurse and a mental health team which is supported by the central Mental Health Unit.
The unit is also working towards formalising collaboration with religious organisations in the communities.
This information was provided in response to a question posed by an attendee at the engagement Pastor Wendell Jeffrey.
Jeffrey, who works with practical Christianity ministries, noted that in Guyana one of the first approaches to displays of mental health issues is to say that persons are suffering from demon possession and therefore to seek religious intervention.
He said religious leaders need to know when they should refer these cases so that they don’t do more harm than good.
Dr Jorge Balsieiro a member of the mental health team explained that the unit has already had engagements with the Wesleyan church which saw more than 70 persons trained in dealing with mental health issues. Another member of the team Dr Indira Harry also noted that she has been leading engagements with persons within the Hindu and Islamic faiths.
Speaking with Stabroek News Jeffrey said that at present persons with mental health issues are not being treated with dignity.
“I don’t think that these people are being treated with enough dignity. There needs to be sensitization, to let people know that the stressors in life can cause any of us to trip. We must remember the saying had not for the grace of god their go I, and be careful that we are treating people the way we want to be treated. People need to be told that mental health conditions are diseases which may be controlled/managed and they also need to be told that it could be them,” Jeffrey explained.
Norton had told Stabroek News last month the psychiatric hospital was being used as a storage bond with vehicle tires, electrical equipment and others items being stored. He said shortly after the government was changed persons were seeing removing “truck loads” of items.
According to Norton, a large sum of money would have to be poured into the institution and a plan would kick in.
He explained that three categories of patients occupy the hospital—geriatric patients who have nowhere else to live; substance abusers who can be rehabilitated and released; and patients who need periodic treatment. The plan would cater for the specific needs of these categories of patients, he said.
Although Norton noted that his ministry has a limited budget, he said very soon a mental health unit with a qualified head would be operational and the hospital would be one of its priorities.
The unit, he said, already exists on paper and will soon be functioning. He added that a coordinator, identified as Leslyn Holder, whom he said is not a psychiatrist but is adequately trained in the United Kingdom to work in the area, will be leading the team.
A building will now have to be acquired to house the unit.
